DEPARTMENT OF COMMUNITY HEALTH

MEDICAL SERVICES ADMINISTRATION

STATE VENDOR PARTICIPATION IN MEDICAL COSTS

(By authority conferred on the department of social services by section 6 of Act No.

280 of the Public Acts of 1939, as amended, being S400.6 of the Michigan Compiled

Laws)

R 400.24 Time limitation on claims by county social welfare board.

Rule 24. All claims incurred and paid by the county social welfare board involving

vendor medical service for which state reimbursement is sought must be submitted to

the county bureau of social aid on a monthly basis but not later than the end of the fifth

month following the month in which the latest continuous service in the same class is

rendered.Provided, that the state department may pay a bill submitted beyond the fifth

month if in its judgment there are extenuating circumstances and if federal

financial participation can be obtained.

History: 1979 AC.

R 400.25 Determination of percentage of state participation.

Rule 25. The commission will redetermine from time to time the percentage

of the costs of hospitalization to be paid by the state department under section

66a of the social welfare act, and such determination shall be applicable to invoices

approved by the supervisor of the bureau of social aid in the month or months

following such determination, regardless of the date the expense for hospitalization

was incurred.

History: 1979 AC.

R 400.26 Enforcement of patient's right to hospitalization.

Rule 26. (1) "Promptly" as used in section 66b of the social welfare act and this

rule shall, in nonemergency cases, be defined as "within 30 calendar days." Failure

of a county department to make a decision promptly on an application for hospitalization

by a person who is receiving old age assistance, aid to dependent children (except a

person so receiving as an eligible child), aid to the blind, or aid to the permanently

and totally disabled, as required by section 66b of the social welfare act, shall be

considered to be a determination that hospitalization is not necessary, and the supervisor

of the bureau of social aid shall then, with the consent of the applicant, petition for a

hearing as provided in sections 66d and 9 of the social welfare act.

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(2) The county social welfare board shall comply with a decision made by the

director of the state department under R 400.7 concerning hospitalization within

5 working days following receipt of the notice of the decision.

(3) If the county social welfare board does not comply with the decision of the

director of the state department as required by subrule (2), the bureau of social aid of the

county department of social welfare shall arrange for or approve the necessary

hospitalization and shall authorize payment by the state department for it.

(4) The county portion of the costs of hospitalization, when incurred under

subrules (2) or (3), shall be recovered by the state department by withholding the

amount from any funds due the county social welfare board by the state department.

History: 1979 AC.

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