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Page 2 of 4 § 10:72-1.1 Program scope iii. Persons determined eligible as specified low-income Medicare beneficiaries are entitled to payment of Medicare Part B Premiums only, beginning in the month of application and up to three prior months. iv. The Division of Medical Assistance and Health Services shall promptly notify any applicant for, or beneficiary of, the specified low-income Medicare beneficiary benefit, in writing, of any agency decision affecting the application disposition or the receipt of the benefit. When a decision relates to any adverse action which may entitle an individual to a fair hearing, the action may not be implemented until at least 10 days after the mailing of the notice. Such notices shall conform with provisions at N.J.A.C. 10:72-5.1(b). (c) Retroactive Medicaid eligibility is available beginning with the third month prior to the month of application for Medicaid for any month during which the applicant meets all eligibility criteria and during which the applicant has unpaid medical expenses for covered services. In order to qualify for retroactive coverage, an individual need not be determined eligible at the time of application for Medicaid benefits. Application for retroactive Medicaid coverage may be made on behalf of a deceased person, so long as the person was alive during a portion of the three-month period immediately prior to the month of application and he or she has unpaid medical expenses for Medicaid covered services. 1. Retroactive Medicaid coverage is not available under the provisions of this chapter for an infant for any period prior to the effective date of program coverage for the age of the child. History HISTORY: Emergency Amendment, R.1988 d.96, effective February 2, 1988 (expired April 2, 1988). See: 20 N.J.R. 548(a). Substantially amended. Adopted Concurrent Proposal, R.1988 d.212, effective May 16, 1988. See: 20 N.J.R. 548(a), 20 N.J.R. 1103(a). Emergency Amendment, R.1991 d.223, effective March 28, 1991 (operative April 1, 1991; expires May 27, 1991). See: 23 N.J.R. 1200(a). Deleted obsolete language and adopted Federally required coverage pursuant to Omnibus Budget Reconciliation Act of 1989. Adopted Concurrent Proposal, R.1991 d.302, effective May 24, 1991. See: 23 N.J.R. 1200(a), 23 N.J.R. 1945(a). Provisions of emergency amendment R.1991 d.223 readopted without change. Emergency Amendment, R.1991 d.445, effective July 29, 1991 (expires September 27, 1991). See: 23 N.J.R. 2543(a). In (c)1: revised text to add 133 percent guideline for retroactive Medicaid coverage. Adopted Concurrent Proposal, R.1991 d.526, effective October 21, 1991. See: 23 N.J.R. 2453(a), 23 N.J.R. 3144(a). Provision of emergency amendment R.1991 d.526 adopted without change. Amended by R.1992 d.484, effective December 7, 1992. See: 24 N.J.R. 1860(a), 24 N.J.R. 4378(a).