Applicant's and Recipient's Responsibility 510-05-20-15

(Revised 01/03 ML #2833)

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(N.D.A.C. Section 75-02-02.1-12.1)

 

1. It is the responsibility of applicants and recipients to provide the information necessary to determine if a health plan is cost-effective.

2. Recipients with a health plan the department has determined is cost-effective must cooperate with all of the conditions or requirements of the health plan. Applicants and recipients are also required to take any optional coverage provided through the plan when it is cost-effective to do so. Failure to cooperate with plan requirements, or to select cost-effective options of the plan, will:

1. Result in termination of payments for the health plan premiums; and
2. Result in nonpayment for services, by Medicaid, which the health plan would pay, or would have paid, had the recipient conformed to the requirements of the health plan.