Exceptions to Timely Promptness

Exceptions to Timely Promptness A. The Division of Medicaid determines eligibility within established standards except in unusual circumstances when a decision cannot be reached including, but not limited to: 1. Failure or delay on the part of the applicant, 2. A disability decision has not been returned by the Disability Determination Service (DDS) or 3. Administrative or other emergency delay that could not be controlled by the agency. B. Time standards are not used in the Division of Medicaid as a waiting period before determining eligibility or as a reason to deny eligibility because the agency has not determined eligibility within the time standards.