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ATTACEME <br /> r <br /> Sl ATE C7r :N©R7H CAROLINA <br /> HU1, <br /> JAMrc n. munr.JR. DEPARTMENT OF HUMAN RESG3Ur-{C�S H H-T1L£O# <br /> pin StioR <br /> .�Division of Health Serulces <br /> SARAH T.HtlRRQW M-L1..,,M.P,H. Raleigh 276O2 <br /> November 6, 198€1 <br /> MUVRA3N DUM <br /> TO•' :-Local. health Directors <br /> _ FR[11t1 Hugh. FC Til sc7n, M.D.; Director { ' � <br /> Division of.'Health Services <br /> 5L1H.7ECT: . Rei xect�Pa t Guidance. Clarification on <br /> bent 1?ay <br /> As a.result of a confusa.ng interpretatio.rL of :federal billin; requixeasents <br /> for..}ledicaid 'seztiices providetl by-jocal health departments, Cory lfenees <br /> xequested"cl.arification`from the Region IV hedicaid, Director The question <br /> :as-&d was_iihethe) a health,depaxtment willing.for Medicaid`services must als: <br /> -I.an inake•a xeasarable collection effort for the same sexvics pravided <br /> to non-Medica3ci..'eligilalesR The following a.s the response of Ftzcliard.l;. klorvis, <br /> Regional Medicaid 1)i•rectox. <br /> 'fA`basic pol.zcy:;that the Medicaid program may no pay fox?services ` <br /> which are prcivided free to ttie general .pub.2ic has' existcrI for gang <br /> eats I3aweI, r Then an 'agency or arganizatiaxz bills,alI thixd ' <br /> party' payars °(such 'as Medicaid,: Xfedzc re or prfvate.i surors) the <br /> services: are no corisidesed tree,W the general.pezt�Iic - Thzs is <br /> true even when theseivices,are liroirlded Free to paxties who do tint <br /> `have any third party, coverage <br /> Basic�Ily Courx�y Health Deparnts• (and odes providers cif €ree. ' <br /> services}, should ask the p tient.1,f third party Lzabi l2ty,coverage <br /> Of. : 1xe services ta. <br /> be pravtded exists: XE the answer is:iri the <br /> negatzve no:Eurthez etfast :is:xequixe3 and the Merlicaid. progxate <br /> can'be T�.�.�led.far the Pledicaa.d eligxb.Ie�R Xt is only in .those iii-` <br /> stances wherein third party Isabs7�ty exists that a reasonable <br /> effoxC X0.col?ectxan. must be made-" <br /> } <br /> ti4ith the exceptxan Qf Fa ily Planni,rig, the decision oTi whether to bill none <br /> the <br /> eligibles is local,one. Such Billing as nbt required by federal <br /> or state xegulati,ons <br />