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)