N.M. Code R. § 8.314.6.20

Current through Register Vol. 35, No. 11, June 11, 2024

Section 8.314.6.20 - RIGHT TO A HSD ADMINISTRATIVE HEARING

A. MAD must grant an opportunity for a HSD administrative hearing as described in 8.314.6.20 NMAC in the following circumstances and pursuant to 42 CFR Section 431.220(a)(1) and (2) , Section 27-3-3 NMSA 1978 and 8.352.2 NMAC:

(1) when an applicant has been determined not to meet the LOC requirement for mi via program services;

(2) when an applicant has not been given the choice of HCBS as an alternative to institutional care;

(3) when an applicant is denied the services of his or her choice or the provider of his or her choice;

(4) when an eligible recipient's services are denied, suspended, reduced or terminated;

(5) when an eligible recipient has been involuntarily terminated from the program;

(6) when an eligible recipient's request for a budget adjustment has been denied; and

(7) when any other adverse action is taken by MAD against the eligible recipient, see 8.352.2 NMAC.

B. DOH and its counsel, if necessary, shall participate in any relevant HSD administrative hearing involving an eligible recipient. HSD's office of general counsel may elect to participate in the administrative hearing. See 8.352.2 NMAC for a complete description, instructions, and hearing process of a HSD administrative hearing for an eligible recipient.

N.M. Code R. § 8.314.6.20

8.314.6.20 NMAC - Rp, 8.314.6.20 NMAC, 10-15-12; A, 2-14-14, Adopted by New Mexico Register, Volume XXVII, Issue 04, February 29, 2016, eff. 3/1/2016