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Page 2 of 4 § 10:72-2.1 Application (c) As part of the application process, an applicant for Medicaid has the responsibility to: 1. Complete, with the assistance of the county social service agency as required, any forms required as part of the application process; 2. Assist the county social service agency in securing evidence that verifies his or her statements regarding eligibility; 3. Provide medical confirmation of pregnancy when Medicaid benefits are sought on that basis; and 4. Submit to necessary medical tests and examinations to determine disability or blindness and provide the county social service agency with evidence relating to that determination. (d) For any application for Medicaid benefits under the provisions of this chapter, the county social service agency must accomplish disposition of the application as soon as all factors of eligibility are met and verified but not later than 30 days from the date of application (or from the date of the inquiry form PA-1C, if applicable) for pregnant women, children, and aged individuals. For disabled and blind individuals, the standard for application disposition is 60 days. Exceptions to the timeliness standard appear in (d)2 below. 1. "Disposition of the application" means the official determination by the county social service agency of eligibility or ineligibility of the applicant(s) for Medicaid. 2. Disposition of the application may exceed the applicable processing standard when substantially reliable evidence of eligibility or entitlement for benefits is lacking at the end of the processing period. In such circumstances, the application may be continued in pending status. The county social service agency shall fully document in the case record the circumstances of the delayed application processing. The processing standard may be exceeded for any of the following: i. Circumstances wholly within the control of the applicant; ii. A determination by the county social service agency, when evidence of eligibility or entitlement is incomplete or inconclusive, to afford the applicant additional time to provide evidence of eligibility before final action on the application; iii. An administrative or other emergency that could not reasonably have been avoided; iv. Circumstances wholly beyond the control of both the applicant and the county social service agency. 3. When disposition of the application is delayed beyond the processing standard, the county social service agency shall provide the applicant written notification prior to the expiration of the processing period setting forth the specific reasons for the delay. 4. Each county social service agency director shall establish appropriate operational controls to expedite the processing of applications and to assure maximum compliance with the processing standard. i. The county social service agency shall maintain control records which identify all pending applications which have exceeded the processing standard and the reason therefor. The record shall be adequate to make possible the preparation of reports of such information as may be requested by the Division of Medical Assistance and Health Services. (e) The following actions on an application qualify as disposition of an application for purposes of the processing standard: 1. Approved: The applicant has been determined eligible for Medicaid; 2. Denied: The applicant has been determined ineligible for Medicaid; 3. Dismissed: A decision by the county social service agency that the application process need not be completed because: