10A NCAC 43F .1104. PAYMENT LIMITATIONS

(a)  Assistance as provided for under this Section is subject to the availability of NCHAP funds.

(b)  Assistance as provided for under this Section shall be extended only after all third party payments have been made. NCHAP funds shall be used only for that portion of services not covered by third party payments.  For the purpose of this Rule, third party means any person or entity that is indirectly liable for the cost of medical or dental care, appliances, products, or special therapies.

(c)  When determining patient eligibility, institutions receiving NCHAP funds shall require each patient to supply information concerning third party coverage and to apply for benefits extended under such coverage.  Any patient who either fails to disclose this information or fails to apply for any third party benefits shall be ineligible for assistance under this Section.

 

History Note:        Authority G.S. 130A‑124;

Eff. January 1, 1982.