Section R986-100-138 - Agency Review of Medical Assistance Eligibility(1) An adversely affected party, including the Department of Health and Human Services, may appeal an ALJ or hearing officer decision by requesting agency review.(2) A request for agency review must be made within 30 days after the decision is issued. An untimely request for agency review will be dismissed unless the requesting party can show good cause for the untimely request pursuant to Subsection R986-10-131(2).(3) The Executive Director of the Department or the Executive Director's designee shall conduct the agency review.(4) Agency review is an informal proceeding and shall be conducted in accordance with Section 63G-4-301. (a) The ALJ or hearing officer's decision is suspended until the Executive Director or their designee issues a final decision and order on agency review.(b) A hearing will not be conducted for agency review.(c) A party may submit written comments or arguments within 10 days following notice of the agency review.(d) The agency review may confirm, reverse, or modify the ALJ or hearing officer's decision.(5)(a) Benefits may continue while an agency review is pending.(b) A recipient may decline the continued benefits while agency review is pending by notifying the Department of Health and Human Services in writing.(c) A recipient must repay any benefits received while agency review is pending if a decision denying eligibility is upheld.(6) A decision on agency review is final upon issuance.(7) The Department of Health and Human Services shall take case action within ten calendar days of the date the agency review decision becomes final.Utah Admin. Code R986-100-138
Adopted by Utah State Bulletin Number 2022-13, effective 7/1/2022