Document Category: Health Benefits/NC Medicaid

I. INTRODUCTION II. REQUESTING TBI WAIVER SERVICES III. BUDGETING IV. TBI PARTICIPATION V. TBI RECERTIFICATION VI. CHANGES IN SITUATION VII. NOTICES VIII. APPEALS

  BACKGROUND & INTRODUCTION PACE AND MEDICAID REFERRAL PROCEDURES ELIGIBILITY DOCUMENTATION FOR PACE POLICY PRINCIPLES PACE BUDGETING ALLOWABLE DEDUCTIONS MEDICAID AUTHORIZATION FOR PACE SERVICES MEDICAID CERITIFCATION AND AUTHORIZATION FOR PACE REDETERMINATION OF ELIGIBILITY/REVIEW CHANGE IN SITUATION AUTOMATED AND MANUAL NOTICES FOR PACE SERVICES PACE APPLICATION REPORT PACE SERVICES – INTERNAL APPEAL PROCESS MEDICAID APPEAL PROCESS

I. INTRODUCTION II. WHEN TO USE LTC BUDGETING III. EXCEPTIONS TO LTC BUDGETING IV. DETERMINING ELIGIBILITY FOR THE MONTHS PRIOR TO LONG-TERM CARE BUDGETING V. LONG TERM CARE BUDGETING COMPUTATION VI. THE COMMUNITY SPOUSE INCOME ALLOWANCE (SPOUSE IN PLA) VII. THE DEPENDENT FAMILY MEMBER ALLOWANCE VIII. UNMET MEDICAL NEEDS ALLOWANCE IX. REPORTING PATIENT MONTHLY LIABILITY…

RULES FOR USE OF FULL INCOME LEVEL OR 1/3 REDUCTION 1/3 REDUCTION

I. INTRODUCTION II. DEFINITIONS III. POLICY PRINCIPLES IV. ALIENS EXEMPT FROM SPONSOR DEEMING V. IMMIGRANTS AFFECTED BY ALIEN SPONSOR DEEMING VI. BATTERED ALIEN EXEMPTION VII. INDIGENT ALIEN EXEMPTION VIII. SPONSORSHIP VERIFICATION AND DOCUMENTATION IX. INCOME POLICY X. RESOURCES XI. TIME LIMIT FOR SPONSOR DEEMING