N.Y. Comp. Codes R. & Regs. tit. 9 § 9620.1

Current through Register Vol. 46, No. 43, October 23, 2024

Section 9620.1 - Investigation

(a) The contractor is responsible for reviewing all aspects of eligibility and obtaining verification of information received. Appropriate inquiry shall be made of the applicant and secondary sources of information as the efficient administration of the program may require taking into account the administrative costs of full review and verification of each application and the need to maintain the fiscal integrity of the program. In this respect the contractor may defer full review and verification or fully review and verify only a statistically valid random sample of the applications filed with the approval of the executive director.

(b) Any review and verification of eligibility shall be conducted in a manner that will not result in practices that violate an applicant's or participant's constitutional rights. An applicant or participant shall be permitted to appear with an attorney or other representative at any interview, conference or redetermination with a representative of the contractor, whenever such interview, conference or redetermination relates the questions of eligibility for assistance, or the amount of the registration fee, premium or deductible which the person interviewed is or was required to pay.

N.Y. Comp. Codes R. & Regs. Tit. 9 § 9620.1