9 CRR-NY 9610.4NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 9. EXECUTIVE DEPARTMENT
SUBTITLE KK. PROGRAM FOR ELDERLY PHARMACEUTICAL INSURANCE COVERAGE
PART 9610. APPLICATION AND DETERMINATION OF ELIGIBILITY
9 CRR-NY 9610.4
9 CRR-NY 9610.4
9610.4 Decision on eligibility.
(a) Decision on eligibility is the conclusion or determination reached in the application process. Such decision shall constitute the decision of the contractor. The decision shall be one of the following:
(1) Accepted for coverage.
This means that eligibility has been established through review and verification to the satisfaction of the contractor.
(2) Not accepted for coverage.
Applications are denied when:
(i) in the course of the application process the information given by the applicant establishes, without the need for further review and verification, that he/she is ineligible;
(ii) ineligibility is determined in the course of or upon completion of a review and verification, or if the applicant refuses to comply with any requirement essential to the determination of eligibility; or
(iii) the application is incomplete.
(3) No decision is required when:
(i) an application is withdrawn by the applicant; or
(ii) the contractor documents that the applicant has died, cannot be located, or has left the State prior to the completion of the review and verification.
(b) The applicant shall be notified in writing of the decision in accordance with these regulations.
9 CRR-NY 9610.4
Current through September 15, 2021
End of Document

IMPORTANT NOTE REGARDING CONTENT CURRENCY: JULY 31, 2023, is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Admisnistrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of the NYS Rules.