Haw. Code R. § 17-1735.1-3

Current through September, 2024
Section 17-1735.1-3 - Effective date of authorization
(a) The effective date for payments to be made for covered services under the fee-for-service program for an individual described in section 17-1735.1-2 shall be:
(1) The date the application is received by the department as described in chapter 17-1711.1;
(2) Any date specified by the individual on which appropriate Medicaid eligible services were incurred and is no earlier than the first day of the third month prior to the month the application is received by the department for an individual applying for the coverage of long-term care services, or the immediate ten calendar days prior to the date the application is received by the department for all other individuals; or
(3) The date when all eligibility requirements are met by the applicant.
(b) An applicant's eligibility for medical assistance within a retroactive period is established when:
(1) A submittal of a signed application is received from an applicant, an individual or department's representative on behalf of a deceased individual.
(2) Part or all of the individual's medical bills remain unpaid;
(3) The expenses incurred by the individual were for medical care and services within the scope of services covered under the fee-for-service program as described in chapter 171737 and authorization for medically necessary services approved as described in chapter 17-1739.1; and
(4) The care and services were provided by an eligible participating provider.

Haw. Code R. § 17-1735.1-3

[Eff 09/30/13] (Auth: HRS § 346-14; 42 C.F.R. §431.10 ) (Imp: HRS § 346-14; 42 C.F.R. §§435.914, 440.10, 440.20, 440.30, 440.40, 440.50, 440.60, 440.70, 440.80, 440.90, 440.100, 440.110, 440.120, 440.130, 440.140, 440.150, 440.155, 440.160, 440.165, 440.166, 440.167, 440.168, 440.169, 440.170, 440.180, 440.181, 440.185 )