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Virginia Administrative Code
Title 12. Health
Agency 5. Department of Health
Chapter 200. Regulations Governing Eligibility Standards and Charges for Medical Care Services to Individuals
2/5/2026

12VAC5-200-80. Application process and termination of services.

A. Upon an applicant's request for medical care services, except the services described in 12VAC5-200-150 and 12VAC5-200-160, the applicant or the applicant's authorized representative shall provide to the department accurate information and documentation regarding the applicant's family size, financial status, and other data needed to register the applicant as a patient and classify the applicant into the appropriate income level.

B. The department shall record the applicant's eligibility date as the date on which the applicant signs the Patient Application and Consent for Health Care.

C. If an applicant needs emergency medical services, the district director or the district director's designee shall waive this application process for that individual until the individual is able to participate in the interviewing process.

D. The district director may terminate medical care services to a patient if the patient fails to make a payment for medical care services or other goods or services received from the department within 90 days after receiving the goods or services. The district director may not terminate services without (i) giving notice to the patient or patient's authorized representative of the intent to terminate, (ii) determining that terminating services would not be detrimental to the patient's health, and (iii) for individuals receiving ongoing care, making a good faith effort to secure alternative care.

Statutory Authority

§§ 32.1-11 and 32.1-12 of the Code of Virginia.

Historical Notes

Derived from VR355-39-100 § 3.1, eff. December 1, 1993; amended, Virginia Register Volume 20, Issue 22, eff. August 11, 2004; Volume 42, Issue 9, eff. January 29, 2026.

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