36-2954. Erroneous eligibility determination; state liability

If the director determines through the grievance and appeal procedure pursuant to a grievance or appeal filed by an applicant that the administration made an error in eligibility determination pursuant to section 36-2933 and a person was incorrectly determined to be ineligible to receive institutional or home and community based services, the administration shall reimburse a provider or noncontracting provider for unreimbursed services provided to the applicant. The administration shall only make reimbursements for services pursuant to this article and from the date the person was incorrectly determined to be ineligible so long as the person remains eligible or until the person is enrolled in the system, whichever is applicable.

36-2954. Erroneous eligibility determination; state liability

If the director determines through the grievance and appeal procedure pursuant to a grievance or appeal filed by an applicant that the administration made an error in eligibility determination pursuant to section 36-2933 and a person was incorrectly determined to be ineligible to receive institutional or home and community based services, the administration shall reimburse a provider or noncontracting provider for unreimbursed services provided to the applicant. The administration shall only make reimbursements for services pursuant to this article and from the date the person was incorrectly determined to be ineligible so long as the person remains eligible or until the person is enrolled in the system, whichever is applicable.