Document Category: Health Benefits/NC Medicaid

I. PURPOSE II. LEGAL RESPONSIBILITY AND REFERENCES III. NORTH CAROLINA GENERAL STATUTES IV. FRAUD VS. MISREPRESENTATION V. PREVENTION VI. DETECTION VII. INVESTIGATIONS VIII. CALCULATING OVERPAYMENTS IX. CONCLUSIONS AND RECOMMENDATIONS X. NOTICES AND APPEALS XI. ADMINISTRATIVE COLLECTION PROCEDURES XII. BANKRUPTCY XIII. DISTRIBUTION OF CASH REPAYMENT XIV. EPICS REPORTING REQUIREMENTS XV. NC DEBT SETOFF (TAX INTERCEPT) CRITERIA…

INTRODUCTION POLICY PRINCIPLES PHYSICIAN SERVICES CLINIC SERVICES HOSPITAL INPATIENT SERVICES HOSPITAL OUTPATIENT SERVICES NURSING FACILITY SERVICES PSYCHIATRIC AND PSYCHOLOGICAL SERVICES RESIDENTIAL SERVICES MENTAL HEALTH CENTERS STATE AND PRIVATE MENTAL HOSPITALS NORTH CAROLINA SPECIALTY HOSPITALS DENTAL SERVICES CHIROPRACTORS PODIATRISTS HOSPICE DURABLE MEDICAL EQUIPMENT (DME) HOME HEALTH SERVICES IN-HOME CARE FOR ADULTS (IHCA) AND IN-HOME CARE FOR…

I. INTRODUCTION II. POLICY PRINCIPLES III. WHEN A DETERMINATION OF BLINDNESS IS NOT REQUIRED IV. REDETERMINATION AND BENEFICIARIES NEEDING AN INITIAL BLINDNESS DETERMINATION V. SUBMITTAL PROCEDURES FOR DSB-2202 “REPORT OF EYE EXAMINATION” VI. SPECIAL PROCEDURES FOR REAPPLICATIONS

DHB ADMINISTRATIVE LETTER NO:02-25, Living Arrangement And Medicaid Suspension/Termination For Incarcerated Beneficiaries

I. INTRODUCTION II. PRINCIPLE III. UNITED STATES CITIZEN IV. CITIZENSHIP AND IDENTITY REQUIREMENTS AT APPLICATION V. CITIZENSHIP AND IDENTITY REQUIREMENTS AT REDETERMINATION VI. CITIZENSHIP AND IDENTITY DOCUMENTATION VII. HIERARCHY CHARTS: ACCEPTABLE DOCUMENTATION OF CITIZENSHIP AND IDENTITY VIII. COLLECTIVE NATURALIZATION

I. INTRODUCTION II. PROCEDURES TO VERIFY CITIZENSHIP AND IDENTITY USING SSA DATA MATCH