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N.J.A.C. 10:71-2.9 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 71. MEDICAID ONLY > SUBCHAPTER 2. THE APPLICATION PROCESS § 10:71-2.9 Process of establishing eligibility The process of establishing eligibility involves a review of the application for completeness, consistency, and reasonableness. A personal face to face interview with the applicant or his/her authorized agent is required. Annotations Notes Chapter Notes Case Notes County board of social services did not comply with required deadlines in governing regulations when it considered whether a petitioner's eligibility for "Medicaid Only" Institutional Medicaid, with the result that the eligibility date of July 1, 2015 that was granted by the board was incorrect and the petitioner was entitled to an eligibility date of May 1, 2015. Among other failures, the board did not comply with its duty to write to the petitioner and explain the reasons for delay and failed to inform the petitioner of the need for a Qualified Income Trust (QIT) in a timely manner. Because the manner in which the board processed the application was improper, an earlier eligibility date was appropriately granted. J.E., Petitioner, v. Passaic Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 15778-15, 2016 N.J. AGEN LEXIS 120, Initial Decision (March 10, 2016). 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). Research References & Practice Aids CROSS REFERENCES: Determination of continuing eligibility, see N.J.A.C. 10:71-8.1.