New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 71 - MEDICAID ONLY
Subchapter 1 - INTRODUCTION
Section 10:71-1.6 - Basic principles of administration
Universal Citation: NJ Admin Code 10:71-1.6
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The following principles of administration shall apply to the Medicaid Only program.
1. Any aged, blind or disabled
person who believes he/she is eligible shall be assured an opportunity to make
application (including reapplication) for Medicaid Only by completing the
appropriate application form.
2.
The applicants or beneficiaries are the primary source of information. However,
it is the responsibility of the agency to make the determination of eligibility
and to use secondary sources when necessary, with the applicant's knowledge and
consent.
3. No duplication of
assistance: No beneficiary of Medicaid Only shall receive, during the same
period, any other medical assistance from the State or any political
subdivision thereof with respect to any maintenance requirements or other need
for which allowance is made in the Medicaid Only program (see
10:71-3.14 regarding inmates of
correctional institutions). The food stamp program is not considered a
duplication of public assistance.
4. There shall be strict adherence to law and
complete conformity with administrative policies. Requirements other than those
established by law or regulations shall not be imposed on any person as a
condition of receiving medical assistance.
5. The applicants or beneficiaries shall have
the right to request appeal on the action or inaction of the agency whenever
they believe that they have not been given full consideration under the law. A
fair hearing shall be conducted by an impartial official of the Department of
Human Services in accordance with prescribed procedure when:
i. An application for Medicaid Only is
denied;
ii. An application for
Medicaid Only is not acted upon by the county welfare board within 30 days for
the aged and 60 for the disabled or blind; or
iii. Medicaid Only is terminated.
6. Information about applicants
and beneficiaries and their circumstances shall not be disclosed except as
required for the proper and efficient administration of the program and only to
those agencies involved in the lawful administration or operation of public
welfare functions or services.
7.
There shall be no discrimination on grounds of race, color, religion, sex,
national origin or marital, parental or birth status by state or local agencies
in the administration of any public assistance program.
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