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UNOFFICIAL 1711.1-15 unless the department determines eligibility for medical assistance. (c) The applicant shall be subject to departmental fraud penalties or recovery requirements for false or withheld information. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §435.911, 435.930, 435.945) (Imp: 42 C.F.R. §435.911, 435.930, 435.945)

§17-1711.1-32 Determination of eligibility for Medicaid. (a) The department shall determine eligibility according to federal and State regulations and policies. The decision regarding eligibility or ineligibility shall be supported by facts in the applicant's record. Each application shall be determined as eligible or ineligible unless the application is withdrawn or discontinued under section 17-1711.1-22. (b) Timely dispositions of eligibility or ineligibility shall be made within: (1) Ninety days from the date of application for an applicant applying for medical assistance on the basis of disability including applications for long-term care; or (2) Forty-five days from the date of application for all other applicants. (c) A determination of eligibility or ineligibility shall be completed within the applicable time standards except in unusual circumstances such as: (1) A delay or failure of an applicant or appropriate required agency to take required action; or (2) An administrative or other type of emergency beyond the department's control. (d) The department shall not use the time standards specified in paragraph (b) of this section as a waiting period before determining eligibility or for a denial due to failure of the department to determine eligibility timely.