23 Miss. Code. R. 208-2.12

Current through August 31, 2024
Rule 23-208-2.12 - Hearings and Appeals
A. The waiver person or his/her representative may request to present an appeal through a local-level hearing, a state-level hearing, or both. The request for a local or state hearing must be made in writing by the person or his/her legal representative.
B. The waiver person may be represented by anyone he/she designates. If the person elects to be represented by someone other than a legal representative, he/she must designate the person in writing.
C. The person has thirty (30) days from the date the appropriate notice is mailed to request either a local or state hearing. This thirty (30) day filing period is extended if the person can show good cause for not filing within (30) days.
D. A hearing cannot be scheduled until a written request is received by either the MDRS or the State Division of Medicaid office. If the written request is not received within the thirty (30) days of the NOA, services will be discontinued.
E. At the local hearing level, MDRS issues a determination within thirty (30) days of the date of the initial request for a hearing.
F. The person has the right to appeal a local hearing decision by requesting a State hearing; A State hearing request must be made within fifteen (15) days of the mailing date of the local hearing decision.
G. At the State hearing level, the Division of Medicaid issues a determination within ninety (90) days of the date of the receipt initial request for a for a State Fair hearing.
H. The waiver person or his representative has the following rights in connection with a local or state hearing:
1. The right to examine at a reasonable time before the date of the hearing and during the hearing the contents of the applicant or recipient's case record.
2. The right to have legal representation at the hearing and to bring witnesses.
3. The right to produce documentary evidence and establish all pertinent facts and circumstances concerning eligibility.
4. The right to present an argument without undue interference and to question or refute testimony or evidence, including an opportunity to confront and cross-examine adverse witnesses.
I. Services must remain in place during any appeal process, except when there is a threat of harm of the person or the service provider.

23 Miss. Code. R. 208-2.12

42 C.F.R. Part 431, Subpart E; Miss Code Ann. §§ 37-33-157, 43-13-117, 43-13-121.
Adopted 1/1/2017
Amended 9/1/2019