1. A program that is also an institution for mental diseases may submit a request for reimbursement of medical expenses if:
a. The individual is deemed eligible for the substance use disorder treatment voucher in accordance with subsection 5 of section 75-09.1-11-07;
b. The individual's suspension of medical assistance is due to the individual being in an institution for mental diseases;
c. The program properly documents and submits a request for medical expenses reimbursement in the form and manner prescribed by the department;
d. The program allows the department access to necessary records to determine if the reimbursement of medical expenses is appropriate;
e. The program submits a new request for reimbursement of medical expenses for each request;
f. The approved payment being made by the department is to reimburse the program's actual cost; and
- g. The department's approved payment does not exceed the total amount appropriated for medical expenses reimbursement.2. Payment on a request for reimbursement of medical expenses may be denied if:- a. A revocation of the program's participation in the voucher system has occurred prior to the date the medical expenses were incurred by the program;
- b. The program fails to comply with the terms and conditions of the signed agreement between the program and the department;
- c. The program fails to comply with or enforce the program's policies submitted as required by subsection 3 of section 75-09.1-11-02;
- d. The program does not have a valid substance abuse treatment program license on the date the medical expenses were incurred by the program;
- e. The program fails to properly document and submit a request for reimbursement of medical expenses in accordance with this section;
- f. The program submits a request for reimbursement of a medical expense that is not an approved expense;
- g. Appropriated funds for the reimbursement of medical expenses have been exhausted;
- h. The program is not an institution for mental diseases; or
- i. The program fails to comply with this section.3. The department shall issue a payment for reimbursement of medical expenses if the request and payment is in accordance with this section and within the limits of appropriated funds for the reimbursement of medical expenses.
History: Effective July 1, 2026.
General Authority: NDCC 50-06-16
Law Implemented: NDCC 50-06-42