§ 143B-1471 — Medicaid services for inmates

North Carolina § 143B-1471

• Jurisdiction: North Carolina
• Ch. 143B: Executive Organization Act of 1973
• Art. 16: Department of Adult Correction

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(a) The Division of Health Services of the Department of Adult Correction and the Department of Health and Human Services shall work together to enable social workers in the Department of Public Safety, Health Services Section, to qualify for and receive federal reimbursement for performing administrative activities related to Medicaid eligibility for inmates. The Department of Adult Correction, Division of Health Services, shall develop policies and procedures to account for the time social workers in the Division of Health Services spend on administrative activities related to Medicaid eligibility for inmates. All social workers in the Division of Health Services who perform administrative activities related to Medicaid eligibility shall be required to receive eligibility determination training provided by the Department of Health and Human Services at least quarterly.
(b) The Department of Adult Correction, Division of Health Services, shall require each social worker performing administrative activities related to Medicaid eligibility for inmates to document the following:
(1) The criteria used by the social worker when deciding to submit an application for Medicaid and when deciding not to submit an application for Medicaid, including any information the social worker believes disqualifies the inmate for Medicaid benefits.
(2) An indication in the social worker’s data entry of an inmate’s Medicaid eligibility as determined by the inmate’s county department of social services.
(3) The number of 24-hour community provider stays prescreened for potential applications, the number of applications submitted, and the number and percentage of applications approved, denied, and withdrawn, which shall be reported to the Health Services Division Director on a monthly basis.
(c) In addition to the requirements in subsection (b) of this section, each Department of Adult Correction, Division of Health Services, social worker performing administrative activities related to Medicaid eligibility for inmates shall submit Medicaid applications and any supporting documents electronically through the ePass portal in the Department of Health and Human Services or through other electronic means, unless paper copies are required by federal law or regulation. (2019-135, s. 3(a); recodified from N.C. Gen. Stat. § 143B-707.5 by 2021-180, s. 19C.9(i), (m).)