173-43-04. Long-term care consultation program: time frames

(A) The program administrator shall complete every long-term care consultation no later than five calendar days after it receives a request for the long-term care consultation, unless the program administrator has an exemption from the five-day time frame under paragraph (B) of this rule.

(B) Exemptions:

(1) If an individual has applied for medicaid coverage, the program administrator shall complete the long-term care consultation in accordance with the applicable time frame for providing a level-of-care determination.

(2) An individual (or the individual's representative) may request that the program administrator provide a long-term care consultation before or after the date required under paragraph (A) of this rule. In such cases, the program administrator shall provide the long-term care consultation at a time that is mutually agreed-upon between the individual (or the individual's representative) and the program administrator.

(3) If the program administrator cannot complete the long-term care consultation before the date required under paragraph (A) of this rule, the program administrator shall provide the long-term care consultation as soon as practicable.

Effective: 12/31/2020
Five Year Review (FYR) Dates: 10/16/2020 and 11/28/2025
Promulgated Under: 119.03
Statutory Authority: 121.07, 173.01, 173.02, 173.42
Rule Amplifies: 173.42 ; 42 U.S.C. 3002, 3012, 3025, 3032
Prior Effective Dates: 06/30/2007, 07/05/2012, 12/19/2013, 08/01/2018, 06/11/2020 (Emer.)