32.1-347 - Eligibility for Program; duty of the Department of Social Services and local welfare or social services agencies; data required.
§ 32.1-347. Eligibility for Program; duty of the Department of SocialServices and local welfare or social services agencies; data required.
A. The Board of Medical Assistance Services shall promulgate regulations toestablish uniform eligibility criteria by defining those persons who willqualify for payment for medical care under the Program. Such criteria shallinclude, but not be limited to, the following:
1. To be eligible, a person shall have net countable income, determined inaccordance with the Board of Medical Assistance Services' regulations, equalto or less than 100 percent of the federal nonfarm poverty level as publishedfor the then current year in the Code of Federal Regulations, except thatlocalities which in fiscal year 1989 used an income level higher than 100percent of the federal nonfarm poverty level may continue to use the sameincome level; and
2. To be eligible, a person shall have net countable resources, determined inaccordance with the Board of Medical Assistance Services' regulations, equalto or less than the then current resource standards of the federalSupplemental Security Income Program.
Further, as a condition of eligibility, the Department of Medical AssistanceServices shall require all legally competent applicants and recipients toassign to the Commonwealth any and all rights to third party benefits,whether contractual or otherwise, including medical support or payments, towhich the applicants and recipients may be entitled. All applicants andrecipients shall also agree to cooperate with the Department in obtainingsuch third party benefits. Such an assignment shall not preclude a court fromapportioning sums which would be subject to the provisions of § 8.01-66.9.
B. Eligibility under this Program shall be determined by the Department ofSocial Services through the local boards of welfare or social services uponapplication for assistance under this program from residents of suchlocalities. The eligibility criteria established by the Board pursuant tothis section shall be used in processing all such applications. The localdepartments of welfare or social services shall certify to the applicant andDepartment of Medical Assistance Services within thirty days of receipt ofeach application whether the person applying meets such criteria.
C. Administrative appeal of adverse eligibility decisions shall be conductedby the Department using the procedures applicable to applicants for Medicaidbenefits under the State Plan for Medical Assistance pursuant to Chapter 10(§ 32.1-323 et seq.) of this title.
D. The State/Local Hospitalization Program shall be established in the booksof the Comptroller so as to segregate the amounts appropriated and theamounts contributed thereto by the localities. No portion of the State/LocalHospitalization Program shall be used for a purpose other than that describedin this chapter. Any state funds remaining at the end of the fiscal yearshall not revert to the general fund but shall remain in the State/LocalHospitalization Program to be used as an offset to the calculated local sharefor the following year. Any local share money remaining at the end of thefiscal year or the biennium shall remain in the locality's account under theState/Local Hospitalization Program to be used by the Department as an offsetto the calculated local share for the following year.
(1989, cc. 657, 746; 1992, c. 104; 1994, c. 297; 1996, cc. 782, 792.)