10:71-2.1 Definitions
The following words and terms, when used in this chapter, shall have the following
meanings unless the context clearly indicates otherwise:
"Application process" means all activity performed by the Income Maintenance Section
relating to a request for medical assistance payments. The application process is primarily
geared toward the determination of basic eligibility. However, since intake by its very nature
involves a combination of services and income maintenance functions, a service worker
shall be available as required during such process.
"Applicant," in Medicaid Only, means the aged, disabled or blind individual or his/her
authorized agent who executes the formal written application (PA- 1G).
"Approved" means that the applicant has been determined to be eligible for Medicaid Only.
"CBOSS" means county board of social services.
"Disposition of the application" means the official determination of the CBOSS that one of
the following actions is appropriate: approval or rejection as defined in the section.
"MRT" means Medical Review Team.
"New application" means a written request for assistance from an individual or his/her
agent who has never previously requested assistance in any county in the State under the
Medicaid Only program.
"Pending application" means the general term for application, reapplication, reopened
application or transfer application prior to official disposition.
"Poverty guidelines" means, with respect to a household, the income poverty line as
prescribed and revised at least annually pursuant to 42 U.S.C. § 9902(2). The poverty
guidelines are a simplified version of the Federal Government's statistical poverty thresholds
used by the Census Bureau to prepare its statistical estimates of the number of persons and
families in poverty. The poverty guidelines issued by the Department of Health and Human
Services pursuant to 42 U.S.C. § 9902(2) are used for administrative purposes, for example,
for determining whether a person or family is financially eligible for assistance or services
under a particular Federal program.
"Reapplication" means a written request for assistance by the individual whose previous
application was rejected in any county in the State and who requests reconsideration of
his/her current eligibility for Medicaid Only.
"Registration" means the action of the CBOSS in assigning a control number to an
application.
"Rejected" is an inclusive term (for statistical purposes) for the following actions:
1. Denied means that the applicant has been determined to be ineligible for assistance for
a specific reason.
2. Dismissed means official recognition that eligibility need not be considered further
because:
i. The applicant died (however, if there were unpaid medical bills incurred subsequent to
inquiry or application, whichever occurred first, the application process is to be completed);
or
ii. The applicant cannot be located; or
iii. The application was registered in error; or
iv. The applicant moved to another county in New Jersey during the application process.
3. Withdrawn means that the applicant decided not to pursue the application further.
"Reopened application" means a written request by a former beneficiary in any county in
the State for reconsideration of his or her current eligibility for the program.
"Transfer application" means a written request for assistance by the individual who at the
time of registration is still receiving assistance through the CBOSS of another county from
which he or she moved.