N.Y. Comp. Codes R. & Regs. Tit. 18 §§ 360-2.5

Current through Register Vol. 46, No. 50, December 11, 2024

Section 360-2.5 - Notification of acceptance/denial

The social services district must notify applicants promptly on State-prescribed forms of MA eligibility decisions.

(a) Notice of acceptance. The social services district will provide eligible applicants with a notice on a State-prescribed form accepting the MA application. The notice will explain what MA care and services are authorized. It must also list any limitations. The notice must clearly indicate when only part of the cost of a particular service will be allowed. If an applicant is liable for part of the cost of care, the district will supply information on allowed costs to the applicant's service provider.

(b) Notice of denial. The social services district must provide ineligible applicants with a notice on a State-prescribed form denying the application. The notice of denial must be adequate, as defined in section 358-2.2 of this Title.

(c) If an applicant is denied MA on the basis of a denial of an application for ADC or HR, a single notice may be sent advising the applicant of both determinations. The notice must separately and adequately advise the applicant of the determination of MA ineligibility.

N.Y. Comp. Codes R. & Regs. Tit. 18 §§ 360-2.5