10A NCAC 21D .0302       AGE 55 AND OVER

(a)  For individuals age 55 and over recovery shall be claimed for Medicaid payments for the following services and benefits:

(1)           Nursing facility level of care;

(2)           Home and community based alternatives services;

(3)           Related hospital care received during approved care under either Subparagraph (1) or (2) of this Paragraph;

(4)           Prescription drugs received during approved care under either Subparagraph (1) or (2) of this Paragraph; and

(5)           Medicare premiums paid during the time of approved care under either Subparagraph (1) or (2) of this Paragraph.

(b)  The amount of recovery shall be limited to the amount of Medicaid payments and benefits described in Paragraph (a)(1)-(5) of this Rule.

(c)  No recovery shall be claimed if the recipient is survived by one or more relatives listed in Section .0100 of this Subchapter.

(d)  No recovery shall be claimed if the Division of Medical Assistance determines under provisions of Section .0500 of this Subchapter that it is not cost effective or if recovery would create undue hardship to a survivor.

 

History Note:        Authority G.S. 108A-70.5; 42 U.S.C. 1396p.;

Temporary Adoption Eff. May 6, 1996 to expire on July 1, 1996, or the last day of the 1996 session of the General Assembly, whichever is later;

Temporary Rule Expired on July 1, 1996;

Eff. July 1, 1996.