N.J. Admin. Code § 10:142-9.3

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:142-9.3 - Fair hearings

(a) Fair hearings under this chapter shall be conducted pursuant to the Administrative Procedure Act, N.J.S.A. 52:14B-1 et seq., and 52:14F-1 et seq., and the Uniform Administrative Procedure Rules, N.J.A.C. 1:1.

(b) A fair hearing must be requested within 20 days of receipt of the adverse agency decision by writing or faxing to:

Division of Medical Assistance and Health Services

Fair Hearings Unit

PO Box 712

Trenton, New Jersey 08625-0712

Fax: (609) 588-2435

(c) A fair hearing request will operate as a stay of any adverse agency action pending the outcome of the matter under appeal.

(d) Once a stay of the adverse agency action is applied, participant directed services shall not be suspended, reduced, or terminated prior to the completion of the fair hearing and the rendering of a final decision.

(e) An exception to (d) above shall be afforded when a change in the participant's situation occurs, affecting eligibility or award of services under the program, while the decision of the administrative review is still pending and the participant does not request an additional administrative review related to the subsequent adverse agency action.

(f) Upon completion of the fair hearing process, a final decision regarding the matter in dispute shall be rendered by the Director of the Division of Medical Assistance and Health Services.

(g) If the applicant or eligible consumer objects to the final decision made in accordance with (f) above, a notice of appeal may be filed by the applicant or eligible participant with the Appellate Division of the Superior Court of New Jersey. Such appeals shall be made within 45 days of the final decision date pursuant to R. 2:4-1(b).

(h) Further information about filing a notice of appeal may be obtained by calling or writing the Appellate Division of the Superior Court of New Jersey at:

Richard J. Hughes Justice Complex

PO Box 006

Trenton, New Jersey 08625-0006

(609) 292-4822

N.J. Admin. Code § 10:142-9.3

Adopted by 49 N.J.R. 3993(a), effective 12/18/2017