10A NCAC 39A .0907. BILLING THE RYAN WHITE HIV CARE PROGRAM

(a)  If an eligible person's individual/family annual gross income is 100 percent or below the official Federal Poverty Guidelines, the care consortium may bill the RWCP the RWCP Reimbursement Rate.  The care consortium must assure that an eligible person in this income category is not billed.

(b)  If an eligible person's individual/family annual gross income is greater than 100 percent of the Federal Poverty Guidelines, the care consortium may bill the RWCP as follows:

(1)           85 percent of the RWCP Reimbursement Rate if the eligible person's gross annual income is between or includes 101 percent and 130 percent of Federal Poverty Guidelines;

(2)           70 percent of the RWCP Reimbursement Rate if the eligible person's gross annual income is between or includes 131 percent and 160 percent of Federal Poverty Guidelines;

(3)           55 percent of the RWCP Reimbursement Rate if the eligible person's gross annual income is between or includes 161 percent and 190 percent of Federal Poverty Guidelines;

(4)           40 percent of the RWCP Reimbursement Rate if the eligible person's gross annual income is between or includes 191 percent and 220 percent of Federal Poverty Guidelines; or

(5)           25 percent of the RWCP Reimbursement Rate if the eligible person's gross annual income is equal to or greater than 221 percent of Federal Poverty Guidelines.

(c)  An eligible person may be billed for essential health and support services subject to the limitations as set forth in Rule .0908 of this Section.

 

History Note:        Authority G.S. 130A‑223;

Eff. December 1, 1991.