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North Carolina Department of Health and Human Services AGED, BLIND, AND DISABLED MEDICAID MANUAL

MA-200

DEFINITIONS

26 REISSUED 03/01/11 – CHANGE NO. 03-11 (III.) Protective Payee --- A substitute payee appointed when the payee mismanages her money or fails to comply with program regulations.

Prouty (Age 72) Benefits --- Special benefits paid by SSA to persons age 72 or over who have not worked under the Social Security System; payments are minimal.

Psychiatric Residential Treatment Facility (PRTF) --- A facility that provides treatment for children with mental illness or substance abuse/dependency who require services in a non-acute inpatient setting. The child must require supervision and specialized interventions on a 24-hour basis to attain a level of functioning that allows subsequent treatment in a less restrictive setting.

Public Assistance Households --- A Food and Nutrition Services household in which all members receive or are determined eligible to receive SSI, WFFA, or a combination of the two.

Public Charge --- An alien who has become (for deportation purposes) or who is likely to become (for admission/adjustment purposes) solely dependent on government assistance. Government assistance includes Work First, SSI, and Medicaid for Long Term Care only.

Public Institution --- An institution that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control.

Public Law --- A generic name for statutes passed by Congress.

Qualified Alien --- An alien who meets the alien requirements to receive full Medicaid coverage. Qualified aliens potentially are eligible for full Medicaid just like U.S. citizens.

Quality Control (QC) --- A management tool used to determine the accuracy of eligibility and evaluation of needed corrective action.

Quarterly Report --- A form issued quarterly to specified recipients for reporting all income, assets, and other eligibility factors as a requirement for continued benefits.

Reapplication --- A subsequent application when a case has been terminated or suspended.

Rebuttal – The process by which an a/r, the a/r’s spouse or representative proves through a greater weight of evidence factors that eliminate or decrease a sanction period.

Recertification --- A review of all factors of eligibility.

Recipient --- An eligible person whose needs are included in the assistance unit.

Recoupment --- Action to recover overpayments/overissuances made to recipients.

Reenrollment/Redetermination of Eligibility --- A complete review of all eligibility factors.