Rule 23-100-5.17 - Continuation of BenefitsA. If a client or representative requests a hearing within the advance notice period, benefits must be continued or reinstated to the benefit level in effect prior to the planned adverse action.1. Timely Request for Continuation of Benefits. To determine if the request for continuation of benefits is timely, the request must be received by the regional office within twelve (12) days from the notice date. This twelve (12) day period includes the ten (10) day adverse action period plus two (2) days mailing time. If a hearing is requested by telephone, the client must be advised to put the request in writing prior to the end of the specified period. Any hearing requested or dated after this period will not be accepted as a timely request for continuation of benefits.2. Continuation of Benefits When Local Decision is Adverse. The client may request a state hearing if the local hearing is adverse. If benefits have been continued pending the local hearing, then benefits will continue pending a state hearing decision provided the request for the state hearing is made within fifteen (15) days of the date on the Notice of Local Hearing Decision.3. Agency Action Upheld in Final Hearing Decision. When the final hearing decision is adverse to the client, the specialist will terminate or reduce the continued benefits using the original reason for the adverse action. A second (2nd) Notice of Adverse Action is not required.4. The Division of Medicaid has the right to initiate recovery procedures against the client to recoup the cost of any medical services furnished the client under Medicaid and CHIP premiums paid by the Division of Medicaid on behalf of CHIP children, to the extent they were furnished solely based on the provision for continuation of benefits.23 Miss. Code. R. 100-5.17
Miss. Code Ann. § 43-13-116.3 (Rev. 2000).