10A NCAC 39A .0706. BILLING THE DEMONSTRATION PROGRAM

(a)  If a patient's gross family income is 125 percent or less of Federal Poverty Guidelines, the home health agency may bill the Demonstration Program Reimbursement Rate [Rule .0702(21)].  The agency may not bill a patient in this income category.

(b)  If a patient's gross family income is between 125 percent and 200 percent of Federal Poverty Guidelines, the home health agency may bill the program as follows:

(1)           85 percent of the Demonstration Program Reimbursement Rate if the patient's gross family income is between or includes 126 percent and 140 percent of Federal Poverty Guidelines;

(2)           70 percent of the Demonstration Program Reimbursement Rate if the patient's gross family income is between or includes 141 percent and 155 percent of Federal Poverty Guidelines;

(3)           55 percent of the Demonstration Program Reimbursement Rate if the patient's gross family income is between or includes 156 percent and 170 percent of Federal Poverty Guidelines;

(4)           40 percent of the Demonstration Program Reimbursement Rate if the patient's gross family income is between or includes 172 percent and 185 percent of Federal Poverty Guidelines; or

(5)           25 percent of the Demonstration Program Reimbursement Rate if the patient's gross family income is between or includes 186 percent and 199 percent of Federal Poverty Guidelines.

 

History Note:        Filed as a Temporary Rule Eff. March 20, 1989 For a Period of 180 Days to Expire on September 16, 1989;

Authority G.S. 130A‑223;

Eff. August 1, 1989.