Rule 23-300-2.5 - Applicant AppealsAppeals regarding eligibility must be filed with the agency through which the applicant/beneficiary first applied. Agencies include:
A. Mississippi Division of Medicaid, 1. The Mississippi Division of Medicaid is responsible for making eligibility determinations for the following groups: d) Aged, blind and disabled individuals who do not qualify for Social Security Income.2. If the Division of Medicaid determines that an applicant is ineligible for Medicaid, and the applicant disagrees with the decision, the applicant may request a local and/or state hearing by contacting the Regional Office that made the decision or by contacting the Division of Medicaid Central Office.3. Hearing requests must be made within thirty (30) days of the date of the letter providing notice of the adverse action to deny, terminate or reduce Medicaid benefits. All adverse action notices issued to applicants contain their appeal rights and explain how to request a hearing.B. Social Security Agency (SSA), The SSA is the Federal agency charged with the responsibility of determining who is eligible for Supplemental Income (SSI). In Mississippi, individuals who are eligible for SSI are automatically eligible for Medicaid. Applicants who are denied SSI are also denied Medicaid. Applicants/beneficiaries whose entitlement to SSI is terminated also lose Medicaid eligibility. Appeals of SSI decisions must be made through the SSA.
C. The Mississippi Department of Child Protection Services (MDCPS). 1. The Mississippi Department of Child Protection Services (MDCPS) is the State agency charged with the responsibility of determining Medicaid eligibility for foster children in the custody of MDCPS.2. In the event MDCPS denies, terminates or reduces the Medicaid benefits of a foster child, the Division of Medicaid is the agency responsible for handling the appeals of such adverse actions.23 Miss. Code. R. 300-2.5
42 C.F.R. Part 431 Subpart E; Miss. Code Ann. §§ 43-13-116, 43-13-117, and 43-13-121