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N.J.A.C. 10:69-2.19 This file includes all Regulations adopted and published through the New Jersey Register, Vol. 57 No. 12, June 16, 2025 NJ - New Jersey Administrative Code > TITLE 10. HUMAN SERVICES > CHAPTER 69. AFDC-RELATED MEDICAID > SUBCHAPTER 2. THE APPLICATION PROCESS § 10:69-2.19 Use of PA-1C as an application request (a) Individuals who were admitted to a hospital and were subsequently referred to the CSSA through the use of Form PA-1C, AFDC-related Medicaid Inquiry, may be eligible for AFDC-related Medicaid benefits from the date the PA-1C was completed, provided: 1. Such individual was an inpatient at the time the referral was made; 2. Except for good cause, including, but not limited to, hospitalizations lasting for three or more months, the homebound status of the applicant, the CSSA was unable to schedule a timely application appointment, or the hospital failed to inform the applicant to apply at the CSSA, the individual applies for AFDC-related Medicaid benefits within three months after the referral is made. i. If the CSSA determines that the individual had good cause for not applying within three months, an extension may be granted for an additional three months. ii. Newborns of eligible women are deemed to have applied and shall be added to the Medicaid case, effective the date of birth, upon notifying the CSSA of the birth. History HISTORY: Amended by R.2017 d.209, effective December 4, 2017. See: 49 N.J.R. 1789(a), 49 N.J.R. 3729(a). Substituted "CWA" for "CBOSS" throughout; and in (a)2ii, substituted "notifying the CWA of the birth" for "receipt of a valid Form PA-1C". Annotations Notes Chapter Notes NEW JERSEY ADMINISTRATIVE CODE Copyright © 2025 by the New Jersey Office of Administrative Law End of Document