New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 71 - MEDICAID ONLY
Subchapter 3 - ELIGIBILITY FACTORS
Section 10:71-3.15 - County welfare agency responsibility and procedures; eligibility factors
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The CWA shall be responsible for determining income and resource eligibility, as outlined in N.J.A.C. 10:71-4 and 5, for Medicaid Only when the applicant is receiving care in institutions defined in 10:71-3.14(d). This does not include residents of the State psychiatric hospitals, the State schools for persons with intellectual disabilities, Bergen Pines County Psychiatric Hospital and Essex County Hospital Center, which are the responsibility of the Institutional Services Section of the Division of Medical Assistance and Health Services.
(b) When eligibility depends upon the disability or blindness factor, the determination of medical eligibility shall be the responsibility of the Medical Review Team (MRT). The CWA shall furnish the MRT with current, pertinent social and medical information as outlined in this subchapter.
(c) When eligibility for Medicaid Only has been determined, the CWA will complete and process a Medicaid Status File Transaction, Form MAP-1, within 10 working days from the date of such determination. The CWA will issue and distribute Medicaid validation stubs to Medicaid Only beneficiaries who are not in long-term care facilities. The CWA will complete the statement of income available for nursing home payment (PR-1) (formerly PA-3L) when appropriate.
(d) A determination of continuing eligibility shall be made in accordance with N.J.A.C. 10:71-5.
