108A-70.46. Audit of county Medicaid determinations.
(a) Beginning January 1, 2019, the Department of Health and Human Services, Division of Central Management and Support, shall audit county departments of social services for compliance with the accuracy standards adopted under G.S. 108A-70.47 for Medicaid eligibility determinations made within a 12-month period. This audit shall also include an evaluation of compliance with the quality assurance standards under G.S. 108A-70.48 by the county department of social services. Audits shall be conducted for initial Medicaid eligibility determination applications as well as Medicaid reenrollment determinations. The Department shall ensure that every county is audited no less than once every three years.
(b) Beginning 18 months after the Department has implemented the training and certification program under G.S. 108A-26.5, the Department shall include in its audits required under this section a verification that all county departments of social services are in compliance with the certification program requirements for individuals involved in the Medicaid eligibility determination process. (2017-57, s. 11H.22(c), (h); 2018-5, s. 11H.5(a), (d).)
Structure North Carolina General Statutes
North Carolina General Statutes
Chapter 108A - Social Services
Article 2 - Programs of Public Assistance.
§ 108A-25 - Creation of programs; assumption by federally recognized tribe of programs.
§ 108A-25.1A - Responsibility for errors.
§ 108A-25.2 - Exemption from limitations for individuals convicted of certain drug-related felonies.
§ 108A-25.3 - Garnishment of wages to recoup fraudulent public assistance program payment.
§ 108A-26.5 - NC FAST caseworker training and certification program.
§ 108A-27.01 - Income eligibility and payment level for Work First Family Assistance.
§ 108A-27.1 - Time limitations on assistance.
§ 108A-27.2 - General duties of the Department.
§ 108A-27.3 - Electing Counties - Duties of county boards of commissioners.
§ 108A-27.4 - Electing Counties - County Plan.
§ 108A-27.5 - Electing Counties - Duties of the Department.
§ 108A-27.7 - Standard Program County Plan.
§ 108A-27.8 - Standard Program Counties - Duties of Department.
§ 108A-27.10 - Duties of the Director of the Budget/Governor.
§ 108A-27.11 - Work First Program funding.
§ 108A-27.12 - Maintenance of effort.
§ 108A-27.13 - Performance standards.
§ 108A-27.14 - Corrective action.
§ 108A-27.15 - Assistance not an entitlement; appeals.
§ 108A-29 - Priority for employment services.
§ 108A-29.1 - Drug screening and testing for Work First Program applicants and recipients.
§ 108A-31 - Application for assistance.
§ 108A-36 - Assistance not assignable; checks payable to decedents.
§ 108A-37 - Personal representative for mismanaged public assistance.
§ 108A-38 - Protective and vendor payments.
§ 108A-39 - Fraudulent misrepresentation.
§ 108A-41 - (Effective until contingency met see note) Eligibility.
§ 108A-42 - Determination of disability.
§ 108A-43 - Application procedure.
§ 108A-44 - State funds to counties.
§ 108A-46.1 - Transfer of assets for purposes of qualifying for State-county Special Assistance.
§ 108A-47 - Limitations on payments.
§ 108A-48 - State Foster Care Benefits Program.
§ 108A-49 - Foster care and adoption assistance payments.
§ 108A-49.1 - Foster care and adoption assistance payment rates.
§ 108A-50 - State benefits for certain adoptive children.
§ 108A-50.1 - Special Needs Adoptions Incentive Fund.
§ 108A-50.2 - Adoption Promotion Fund.
§ 108A-51 - Authorization for Food and Nutrition Services.
§ 108A-51.1 - Prohibition on certain waivers.
§ 108A-52 - Determination of eligibility.
§ 108A-53 - Fraudulent misrepresentation.
§ 108A-53.1 - Illegal possession or use of electronic food and nutrition benefits.
§ 108A-54.2 - (Effective until contingency met see note) Procedures for changing medical policy.
§ 108A-54.3A - Eligibility categories and income thresholds.
§ 108A-54.4 - Income disregard for federal cost-of-living adjustments.
§ 108A-54.5 - Maintenance of waivers for dependents of members of Armed Forces.
§ 108A-55.1 - Medicare enrollment required.
§ 108A-55.3 - Verification of State residency required for medical assistance.
§ 108A-55.4 - Insurers to provide certain information to Department of Health and Human Services.
§ 108A-55.5 - Eligibility monitoring for medical assistance.
§ 108A-56 - Acceptance of federal grants.
§ 108A-57.1 - Rules governing transfer of medical assistance benefits between counties.
§ 108A-58.2 - Waiver of transfer of assets penalty due to undue hardship.
§ 108A-60 - Protection of patient property.
§ 108A-62 - Therapeutic leave for medical assistance patients.
§ 108A-63 - Medical assistance provider fraud.
§ 108A-63.1 - Health care fraud subpoena to produce documents.
§ 108A-64 - Medical assistance recipient fraud.
§ 108A-64.1 - Incentives to counties to recover fraudulent Medicaid expenditures.
§ 108A-65 - Conflict of interest.
§ 108A-66.1 - Medicaid buy-in for workers with disabilities.
§ 108A-67 - Medicare/Qualified Disabled Working Individuals.
§ 108A-68 - Drug Use Review Program; rules.
§ 108A-68.1 - Certain prescription drugs exempt from prior authorization requirements.
§ 108A-69 - Employer obligations.
§ 108A-70 - Recoupment of amounts spent on medical care.
§ 108A-70.4 - Long-Term Care Partnership Program.
§ 108A-70.5 - Medicaid Estate Recovery Plan.
§ 108A-70.9A - (Effective until contingency met see note) Definitions; Medicaid recipient appeals.
§ 108A-70.9B - (Effective until contingency met see note) Contested Medicaid cases.
§ 108A-70.9C - Informal review permitted.
§ 108A-70.12 - Liability for certain acts; damages; effect of repayment.
§ 108A-70.13 - False claims procedure.
§ 108A-70.14 - Civil investigative demand.
§ 108A-70.15 - Employee remedies.
§ 108A-70.16 - Uniformity of interpretation.
§ 108A-70.37 - Timely decision standards.
§ 108A-70.38 - Timely processing standards.
§ 108A-70.39 - Average processing time standards.
§ 108A-70.40 - Percentage processed timely standards.
§ 108A-70.41 - Corrective action.
§ 108A-70.42 - Temporary assumption of Medicaid eligibility administration.
§ 108A-70.43 - (Effective until contingency met see note) Reporting.
§ 108A-70.46 - Audit of county Medicaid determinations.
§ 108A-70.47 - Medicaid eligibility determination processing accuracy standards.
§ 108A-70.48 - Quality assurance.
§ 108A-70.49 - Corrective action.
§ 108A-70.50 - Temporary assumption of Medicaid eligibility administration.
§ 108A-70.51 - (Effective until contingency met see note) Reporting.