(a) The provider shall participate in training offered by the Division or its agents and make presumptive eligibility determinations in accordance with 42 C.F.R. 435.1103, which is adopted and incorporated by reference with subsequent changes or amendments and available free of charge at https://www.ecfr.gov/, and the Medicaid State Plan.

(b) The Division shall terminate the provider's Medicaid Participation agreement and authority to make presumptive determinations if the provider fails to make required notifications to the county department of social services in the pregnant woman's county of residency within five business days or fails to follow procedures set forth in the Medicaid State Plan, resulting in eligibility denials for a majority of the provider's referrals.

(c) Termination of the agreement shall occur 30 calendar days following notification when termination is initiated by the Division.


History Note: Authority G.S. 108A‑25(b); 42 U.S.C. 1396r1; 42 C.F.R. 435.1103;

Eff. June 1, 1988;

Readopted Eff. July 1, 2018.