Haw. Code R. § 17-1713.1-5

Current through November, 2024

Section 17-1713.1-5 - Timely and adequate notice

(a) Prior to the implementation of any adverse action which affects an individual, a timely and adequate notice shall be sent.

(b) A notice of adverse action shall be considered timely when sent:

(1) At least fifteen (15) calendar days prior to the effective date of adverse action except as described in paragraph (c). When a new address is reported to the department by the individual within the eligible period, a new notice shall be re-issued; or

(2) Five (5) calendar days prior to the effective date of adverse action when the department has evidence of probable fraud by the individual.

(c) Adequate notice shall be sent not later than the date of action when:

(1) The department has factual information confirming the death of an individual;

(2) The department received a clear written statement signed by the individual or authorized representative that:

(A) Medical assistance is no longer wanted; or

(B) Provides information that necessitates termination or reduction of services and indicates the individual understands that the consequences of supplying the information is the reduction or termination of assistance;

(3) The individual has been admitted or committed to a public institution ineligible to receive medical assistance;

(4) The individual is transferred or discharged from a long-term care facility or qualified home and community based home;

(5) The individual's whereabouts are unknown and mail sent to the individual has been returned by the post office indicating no known forwarding address;

(6) The department has verified the individual's receipt of medical assistance in another jurisdiction, state, territory or commonwealth;

(7) A change in the level of medical care is prescribed by the individual's physician; or

(8) Involves an adverse action made in regards to preadmission screening requirements.

Haw. Code R. § 17-1713.1-5

[Eff 09/30/13] (Auth: HRS § 346-14; 42 C.F.R. §§431.206, 431.211, 431.213, 431.214, 435.917) (Imp: HRS § 346-14; 42 C.F.R. §§431.206, 431.211, 431.213, 431.214, 435.917)