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Page 13 of 14 § 10:71-2.2 Responsibilities in the application process documentation had not been provided. M.D. v. Camden Cnty. Bd. Social Serv., OAL Dkt. No. HMA 1459-14, 2014 N.J. AGEN LEXIS 281, Initial Decision (May 22, 2014). An Administrative Law Judge (ALJ) concluded that a county board of social services acted properly when it denied an application for Medicaid eligibility made by an applicant on a finding that the applicant had failed to provide the required verification. The applicant admitted that there were several outstanding requests for documents to which she had not responded. Because the board was required by N.J.A.C. 10:72-2.3(a) and N.J.A.C. 10:71-2.9 to verify all factors related to eligibility, including sources of income and resources, the applicant's conceded failure to comply with those requests per N.J.A.C. 10:71-2.2(e)1 and N.J.A.C. 10:71-3.1(b) to provide the requested items foreclosed a determination that she was eligible for Medicaid. M.D. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 1459-14, AGENCY DKT. NO. 410052818-01, 2014 N.J. AGEN LEXIS 273, Initial Decision (May 22, 2014). Applicant was not eligible for Medicaid benefits after failing to provide sufficient verification pursuant to N.J.A.C. 10:71-2.2(e)2. Although a request for certain bank statements was made on three separate occasions, the applicant produced no documents evidencing compliance with the request. Although he testified that the account might not have existed at the time in question, he produced no evidence of this fact. G.W. v. Camden Cnty. Bd. of Social Serv., OAL Dkt. No. HMA 15781-13, 2014 N.J. AGEN LEXIS 264, Initial Decision (May 12, 2014). Camden County Board of Social Services appropriately denied an application for Medicaid under N.J.A.C. 10:71- 2.2(e)2 when the applicant failed to establish by a preponderance of credible evidence that he provided all of the information necessary to complete his application for benefits. The Board twice notified the applicant of verification documentation that was needed in order for him to establish eligibility. Though he did provide some bank statements as well as handwritten notations on the Board's notice, the applicant did not submit all of the requested information. He admitted as much to a Board worker during a telephone conversation after he received the Board's denial notice. W.B. v. Div. of Medical Assistance and Health Serv. and Camden Cnty. Bd. of Social Serv., OAL Dkt. No. HMA 8393-13, 2014 N.J. AGEN LEXIS 252, Initial Decision (May 6, 2014). An Administrative Law Judge concluded that even though an elderly woman's application for Medicaid's Global Options Assisted Living Waiver Program was not processed in accordance with the requirements in N.J.A.C. 10:71- 2.2 and N.J.A.C. 10:71-2.3(c), the fact was that the applicant was not financially eligible for participation in the program. That is, the processing agencies' failure to comply with those requirements, including the 45-day processing requirement, did not provide a basis for an award of benefits to an otherwise ineligible applicant as such a retroactive award would be in contravention of N.J.A.C. 10:49-22.1(b). A.H. v. Div. of Med. Assistance & Health Servs. and Morris Cnty. Bd. of Soc. Servs., OAL Dkt. No. HMA 00531-13, 2014 N.J. AGEN LEXIS 91, Initial Decision (January 27, 2014). Initial Decision (2007 N.J. AGEN LEXIS 209) adopted, which concluded that an application for Medicaid benefits under the Medically Needy program was correctly denied for the applicant's failure to provide requested information regarding three attempts to sell the subject annuity, which the applicant claimed was an unavailable resource; while the Division may ultimately bear the burden of proving that a market exists, and that this particular annuity could be sold, this did not relieve the applicant of her obligation to produce information the Division requested. D.M. v. DMAHS, OAL Dkt. No. HMA 6394-06, 2007 N.J. AGEN LEXIS 546, Final Decision (June 11, 2007). Medicaid benefits properly provided despite non-compliance; status letter was lost in mail. B.W. v. Division of Medical Assistance and Health Services, 95 N.J.A.R.2d (DMA) 2. Patient not ineligible for Medicaid benefits when status letter containing necessary information from Medicaid office on eligibility was lost in mail. B.W. v. Division of Medical Assistance, 95 N.J.A.R.2d (DMA) 2. NEW JERSEY ADMINISTRATIVE CODE Copyright © 2025 by the New Jersey Office of Administrative Law