Administrative Code

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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
6/30/2022

12VAC5-200-80. Application process.

Upon an applicant's request for medical care services (excepting those services described in 12VAC5-200-150, 12VAC5-200-160, and 12VAC5-200-170) the department will require information as to the family size, financial status and other related data as described on the application for medical care. The applicant must be informed during the interviewing process of the provisions as described in this section of the regulations.

An application date is established when the applicant completes and signs the application for medical care services.

When an applicant is in need of emergency medical services, the district director, or his designee, shall waive this application process for that individual until such time as the individual is able to participate in the interviewing process.

It is the applicant's responsibility to furnish the department with proof of the applicant's financial data in order to be appropriately classified according to income level and family size so that eligibility for discounts for medical care services can be determined.

Any individual who is acting on behalf of an applicant will be responsible for the accuracy of all financial data provided to the department.

Individuals who have failed to make any payment within the past 90 days for medical care services or other goods or services they have received may have their medical care services terminated. The district director may terminate services only following notice to the individual that such services will be terminated and only after determining that terminating services would not be detrimental to the individual's health. Medical care services cannot be terminated for individuals receiving ongoing care without 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.

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