COUNTIES AND COUNTY LAW
HOSPITALS FOR INDIGENT SICK
31-3505. Time and manner of filing applications for financial assistance. Applications for financial assistance shall be filed according to the following time limits. Filing is complete upon receipt by the clerk or the department.
(1) A completed application for nonemergency necessary medical services shall be filed with the clerk ten (10) days prior to receiving services from the provider or the hospital.
(2) A completed application for emergency necessary medical services shall be filed with the clerk any time within thirty-one (31) days beginning with the first day of the provision of necessary medical services from the provider, except as provided in subsection (3) of this section.
(3) In the case of hospitalization, a completed application for emergency necessary medical services shall be filed with the department any time within thirty-one (31) days of the date of admission.
(4) Requests for additional treatment related to an original diagnosis in accordance with a preapproved treatment plan shall be filed ten (10) days prior to receiving services.
(5) A delayed application for necessary medical services may be filed up to one hundred eighty (180) days beginning with the first day of the provision of necessary medical services provided that:
(a) Written documentation is included with the application or no later than forty-five (45) days after an application has been filed showing that a bona fide application or claim has been filed for social security disability insurance, supplemental security income, third party insurance, medicaid, medicare, crime victims compensation, and/or worker’s compensation. A bona fide application means that:
(i) The application was timely filed within the appropriate agency’s application or claim time period; and
(ii) Given the circumstances of the patient and/or obligated persons, the patient and/or obligated persons, and given the information available at the time the application or claim for other resources is filed, would reasonably be expected to meet the eligibility criteria for such resources; and
(iii) The application was filed with the appropriate agency in such a time and manner that, if approved, it would provide for payment coverage of the bills included in the county application; and
(iv) In the discretion of the county commissioners, bills on a delayed application which would not have been covered by a successful application or timely claim to the other resource(s) may be denied by the county commissioners as untimely; and
(v) In the event an application is filed for supplemental security income, an Idaho medicaid application must also have been filed within the department of health and welfare’s application or claim time period to provide payment coverage of eligible bills included in the county application.
(b) Failure by the patient and/or obligated persons to complete the application process described in this section, up to and including any reasonable appeal of any denial of benefits, with the applicable program noted in paragraph (a) of this subsection, shall result in denial of the application.
(6) No application for financial assistance under the county medically indigent program or the catastrophic health care cost program shall be approved by the county commissioners or the board unless the provider or the hospital completes the application process and complies with the time limits prescribed by this chapter.
(7) Any application or request which fails to meet the provisions of this section, and/or other provisions of this chapter, shall be denied.
(8) In the event that a county determines that a different county is obligated, such county shall notify the applicant or third party applicant of the denial and shall also notify the county it believes to be the obligated county and provide the basis for the determination. An application may be filed by the applicant or third party applicant in the indicated county within thirty (30) days of the date of the initial county denial.
[31-3505, added 1996, ch. 410, sec. 8, p. 1363; am. 2000, ch. 317, sec. 3, p. 1071; am. 2004, ch. 300, sec. 2, p. 839; am. 2009, ch. 177, sec. 9, p. 567; am. 2010, ch. 273, sec. 8, p. 698; am. 2011, ch. 291, sec. 9, p. 802; am. 2013, ch. 279, sec. 4, p. 726; am. 2014, ch. 97, sec. 20, p. 283.]