NAC439.773. Order of priority if there is insufficient money available; qualifying hardship; granting of subsidy to applicant on waiting list if sufficient money becomes available.

     1. Except as otherwise provided in subsections 2, 3 and 4, if there is insufficient money available for each applicant from the amount allocated for subsidies by the Department, the Department will rank the applicants whose applications are approved based on their household income. The applicant with the lowest household income will receive priority over the other applicants. If the household income of two applicants is exactly the same amount, the applicant whose application was received earlier by the Department will receive priority over the other applicant.

     2. If an applicant documents a medical condition that will deteriorate rapidly if prescribed medications are not taken, the applicant will receive priority over other applicants on the waiting list, regardless of income level. If two applicants document such emergent medical conditions, the applicant whose application was received earlier by the Department will receive priority over the other applicant.

     3. If the Department determines that an applicant whose income exceeds the established limits has a qualifying financial hardship, the applicant will be ranked on the priority list at his or her adjusted income level, which is the applicant’s actual income minus medical costs or the cost of another qualifying hardship.

     4. If, at any time, the Department determines that there is sufficient money available from the amount allocated for subsidies by the Department for more applicants, the Department may grant a subsidy to an applicant on the waiting list in the order of priority described in this section. If the Department grants a subsidy pursuant to this subsection, the Department will provide written notice to the applicant in the manner set forth in NAC 439.772.

     5. For the purposes of this section, an applicant shall be deemed to have a qualifying hardship if the applicant submits to the Department:

     (a) Documentation satisfactory to the Department that verifies that the monthly cost of prescription drugs, pharmaceutical services or out-of-pocket medical expenses, or any combination thereof, for the applicant’s household is causing a hardship; or

     (b) Documentation satisfactory to the Department that verifies any other hardship of the applicant that the Department determines is a qualifying hardship.

     (Added to NAC by Dep’t of Health & Human Services by R157-05, eff. 11-17-2005)