Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 181 - SPECIAL HEALTH PROGRAMS
Chapter 1 - NEBRASKA CHRONIC RENAL DISEASE PROGRAM
Section 181-1-003 - ELIGIBILITY AND APPLICATION
Current through September 17, 2024
To be eligible for participation in the Chronic Renal Disease Program, an applicant must meet all statutory requirements and the following:
(A) Be diagnosed with chronic kidney disease or chronic renal disease;
(B) Require dialysis to maintain or improve his or her condition. An individual who has received a kidney transplant must have been a client prior to receiving the transplant and must be within three years of receiving the transplant in order to be served;
(C) Annual income must be at or below three-hundred (300) percent of the federal poverty level in order to participate. The income level is adjusted based on household size; and
(D) Accept any Medicaid benefits for which the applicant may be eligible and benefits from any other programs, including any third-party payment, to the maximum extent possible.
003.01 APPLICATION. Clients must submit, through the staff at a licensed health clinic where the client receives dialysis, a complete application provided by the Department and the following:
003.02 APPROVAL. An approved application establishes client eligibility for seven years, provided the client continues to meet the eligibility requirements in this chapter. The service start date for a client is the first day of the month in which the complete Department approved application is received by the Department. The service start date may be adjusted upon the discretion of the Department.
003.03 PROVISIONAL APPROVAL. The Chronic Renal Disease Program may assist clients on a provisional basis subject to the limitations noted in this chapter. Provisional services require additional documentation or explanation at the time of application and are provided for 12 (twelve) months or less after which the client must provide updated documentation to continue participation. Provisional services may be adjusted or discontinued at the discretion of the Department. Client situations which may qualify for provisional approval include:
003.04 DENIAL. When an individual does not meet the eligibility requirements in this chapter, the Department must send adequate notice to the individual stating the reason for the denial.
003.05 RE-APPLICATION. To re-apply after a denial, a new complete application is required.
003.06 PAYMENT. Payment for any services prior to the client's service start date shall not be authorized.
