10A NCAC 39A .0304. APPLICATION PROCESS

(a)  Application for assistance must include a completed statement of financial eligibility and a completed request for authorization of services in accordance with the attending physician's directions.  Requests for additional services shall require a completed authorization request form.  All necessary forms may be obtained from the Division of Public Health.

(b)  Notification of application approval or reason for denial shall be sent to the interested parties within 45 days of the date the application is received by the Department.  The effective date of coverage and the date of termination shall be indicated on the approved application.  Coverage shall not precede the initiation of ESRD therapy, which shall be stated on the authorization request.

(c)  Applications must be renewed annually for the fiscal year beginning July 1, and ending June 30.

(d)  New authorizations for pharmaceutical and incidental supply purchases shall be given an effective date of coverage corresponding to the first day of the month in which the application is received and will expire June 30 of the same fiscal year.  Changes of patient ‑ selected pharmacy during the course of the fiscal year require the approval of the program.  The effective date of the change will be established by the program at the time of approval.  Interested parties will be notified of the change and its effective date.

 

History Note:        Authority G.S. 130A‑220;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; January 1, 1986; July 1, 1984; March 31, 1980.