Guam § 2905 - Program Participation and Eligibility Standards.

§ 2905. Program Participation and Eligibility Standards.

(a) General Eligibility Criteria. To be eligible for Program coverage, an applicant for the Medically

Indigent Program must be a resident of Guam as defined by § 2903(e) of this Article and as further defined

by this Section. In addition, an applicant shall also meet the additional standards for eligibility according to

the following three (3) criteria:

(1) General Eligibility Standards,

(2) Income Limitations, and

(3) Resource Limitations

as established in this Section, § 2905.4, and § 2905.5.

(b) Effective Date of Coverage. Except as specifically required by Federal law, § 2905.3 or by § 2914

of this Article, the Program is only responsible for providing medical coverage effective the first day of the

month of application provided that that person has been determined eligible for the program.

(c) Applications. Applications for the Medically Indigent Program shall be completed by the applicant,

or by someone authorized to act on the applicant’s behalf. Upon receipt of an application, the program shall

investigate and prepare a complete record of the circumstances of the applicant and provide the applicant

with a written response as to the person’s eligibility under the Program.

(d) Application Requirements. Each applicant shall be required to file an affirmation setting forth such

facts about their qualifications for eligibility, annual income and other resources as may be required by the

Program. Such statements shall be on forms prescribed by the Program, and may be accepted as evidence

of the facts stated, but shall not be interpreted to preclude a full and complete investigation by the Program.

(e) System for Quality Reviews (QR). The Administrator shall establish a system for QR of a sufficient

sample size of applications to assure the validity of all applications.

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(f) False Declarations as to Eligibility; Liability for Repayment; Penalty. Any individual receiving

assistance under this Article for which they were not eligible on the basis of false declarations as to their

eligibility, or on behalf of any other person receiving assistance under this Article for which such other

person or persons were not eligible, shall be liable for repayment of all benefits received and shall be guilty

of a misdemeanor or felony depending on the amount paid in that person’s behalf for which the person was

not eligible, as specified in the Criminal and Correctional Code, Title 9 of the Guam Code Annotated.