Section .0100 ‑ Supervision

Link to law: http://reports.oah.state.nc.us/ncac/title 10a - health and human services/chapter 21 - medical assistance administration/subchapter a/subchapter a rules.html
Published: 2015

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CHAPTER 21 ‑ MEDICAL ASSISTANCE ADMINISTRATION

 

SUBCHAPTER 21A ‑ GENERAL PROGRAM ADMINISTRATION

 

SECTION .0100 ‑ SUPERVISION

 

10A NCAC 21A .0101       SUPERVISION (TRANSFERRED TO 10A NCAC 23A

.0101)

section .0200 – DEFINITIONS

 

10A NCAC 21A .0201       DEFINITIONS (TRANSFERRED TO 10A NCAC 23A

.0102)

 

section .0300 - appeals

 

10A NCAC 21A .0301       NOTICE

In cases involving termination or modification of

assistance, no action shall become effective until ten work days after the

notice is mailed or delivered, except that it may be effective immediately when:

(1)           Modification is beneficial to the client; or

(2)           Federal regulations at 42 C.F.R. 431.213 are

adopted by reference pursuant to G.S. 150B‑14(c).

 

History Note:        Authority G.S. 108A‑54; 108A‑79;

150B‑14(c); 42 C.F.R. 431.211; 42 C.F.R. 431.213;

Eff. September 1, 1984;

Amended Eff. August 1, 1990.

 

10A NCAC 21A .0302       GOOD CAUSE FOR DELAYED HEARINGS

(a)  A local appeal hearing shall be delayed for good cause

as provided in G.S. 108A‑79(e).

(b)  A state appeal hearing may be delayed when there is

good cause. The postponement may not exceed 30 calendar days.

(c)  Good cause exists when:

(1)           There is a death in the appellant's family;

(2)           The appellant or someone in his family is

ill;

(3)           The appellant is unable to obtain

representation;

(4)           The appellant's representative has a

conflict with the scheduled date;

(5)           The appellant receives a notice of action

proposing a reduction or termination of assistance after the ten work day

notice expires;

(6)           The appellant is unable to obtain

transportation;

(7)           The hearing officer determines that the

hearing should be delayed for other circumstances satisfactory to the hearing

officer.

 

History Note:        Authority G.S. 108A‑54; 108A‑79;

Eff. September 1, 1984;

Amended Eff. August 1, 1990.

 

10A NCAC 21A .0303       APPEAL DECISION

(a)  The hearing officer shall make a tentative decision

which shall be served upon the county department and the appellant by mail. 

Decisions proposing to reverse the county department's action shall be sent by certified

mail to the county department while decisions affirming the county department's

actions will be sent by certified mail to the appellant.

(b)  The county and the appellant may present oral and

written argument, for and against the decision.  Written argument may be

submitted to or contact made with the Chief Hearing officer to request a

hearing for oral argument.

(c)  If the Chief Hearing Officer is not contacted within 10

calendar days of the date the notice of the tentative decision is signed, the

tentative decision shall become final.

(d)  If the party that requested oral argument fails to

appear at the hearing for oral argument, the tentative decision becomes final.

(e)  If oral and written arguments are presented, such

arguments shall be considered and a final decision shall be rendered.

(f)  The final decision shall be mailed to the appellant any

the county by certified mail.

(g)  A decision upholding the appellant shall be put into

effect within two weeks after receipt of the final decision.

(h)  As provided for in 42 C.F.R. 431.245, the decision

shall contain the appellant's right to request a State agency hearing and seek

judicial review to the extent that either is available to him.

 

History Note:        Authority G.S. 108A‑54; 108A‑79;

42 C.F.R. 431.244; 42 C.F.R. 431.245; 42 C.F.R. 431.246;

Eff. September 1, 1984;

Amended Eff. September 1, 1992.

 

SECTION .0400 ‑ CONFIDENTIALITY AND ACCESS TO CLIENT

RECORDS

 

10A NCAC 21A .0401       SCOPE (TRANSFERRED TO 10A NCAC 23H

.0101)

 

10A NCAC 21A .0402       INFORMATION

FROM OTHER AGENCIES (TRANSFERRED TO 10A NCAC 23H .0102)

 

10A NCAC 21A .0403       CONFIDENTIALITY (TRANSFERRED TO 10A NCAC

23H .0103)

 

10A NCAC 21A .0404       OWNERSHIP OF RECORDS (TRANSFERRED TO 10A

NCAC 23H .0104)

 

10A NCAC 21A .0405       SECURITY OF RECORDS (TRANSFERRED TO 10A

NCAC 23H .0105)

 

10a NCAC 21A .0406       LIABILITY

OF PERSONS WITH ACCESS (TRANSFERRED TO 10A NCAC 23H .0106)

 

10A NCAC 21A .0407       RIGHT OF ACCESS (TRANSFERRED TO 10A NCAC

23H .0107)

 

10A NCAC 21A .0408       WITHHOLDING

INFORMATION FROM THE CLIENT (TRANSFERRED TO 10A NCAC 23H .0108)

 

10A NCAC 21A .0409       PROCEDURE

FOR REVIEW OF RECORDS (TRANSFERRED TO 10A NCAC 23H .0109)

 

10A NCAC 21A .0410       CONSENT FOR RELEASE (TRANSFERRED TO 10A

NCAC 23H .0110)

 

10A NCAC 21A .0411       DISCLOSURE

WITHOUT CLIENT CONSENT (TRANSFERRED TO 10A NCAC 23H .0111)

 

10A NCAC 21A .0412       DOCUMENTATION

OF CONSENT OR DISCLOSURE (TRANSFERRED TO 10A NCAC 23H .0112)

 

10A NCAC 21A .0413       PERSONS

DESIGNATED TO DISCLOSE INFORMATION (TRANSFERRED TO 10A NCAC 23H .0113)

 

SECTION .0500 ‑ QUALITY CONTROL

 

10A NCAC 21A .0501       QUALITY CONTROL (TRANSFERRED TO 10a NCAC

23A .0103)

 

SECTION .0600 ‑ CORRECTIVE ACTIONS IN MEDICAID CASES

 

10A NCAC 21A .0601       GENERAL (TRANSFERRED TO 10A NCAC 23G

.0201)

 

10a NCAC 21A .0602       CORRECTIVE ACTIONS (TRANSFERRED TO 10A

NCAC 23G .0202)

 

10A NCAC 21A .0603       TIME LIMITS FOR CORRECTIONS (TRANSFERRED

TO 10A nCAC 23G .0203)

 

10A NCAC 21A .0604       RESPONSIBILITY FOR ERRORS (tRANSFERRED

TO 10A nCAC 23G .0204)

 

10A NCAC 21A .0605       MONITORING THRESHOLDS AND CORRECTIVE

ACTION (TRANSFERRED TO 10A NCAC 23C .0202)

 

10A NCAC 21A .0606       timeliness (TRANSFERRED TO 10A NCAC 23C

.0203)

 

10A NCAC 21A .0607       local corrective action team

(TRANSFERRED TO 10A NCAC 23C .0204)

 

10A NCAC 21A .0608       state corrective action team

(TRANSFERRED TO 10A NCAC 23C .0205)

 

SECTION .0700 ‑ AVAILABILITY OF MANUALS

 

10A NCAC 21A .0701       AVAILABILITY OF MANUALS (TRANSFERRED TO

10A NCAC 23A .0104)