Section 4-5 - Notice of Right to Hearing and Adverse Action (a) Applicants and clients. Where the right to a hearing is provided by this Chapter, the Department shall provide notice at the time of any adverse action. The notice shall include a statement: - (i) Of the right to a hearing;
- (ii) Of an explanation of:
- (A) The individual's right to request a hearing; or
- (B) That in cases of action based on a change in law, the circumstances under which a hearing will be granted;
- (iii) Of the method for requesting a hearing;
- (iv) That the applicant or client has the right to be represented by a legally authorized representative, including a lawyer admitted to practice in Wyoming, or a relative, friend or other spokesman;
- (v) That the applicant or client must notify the Department in writing that they will be represented by any of the representatives listed in Section 5(a)(iv);
- (vi) Of the intended action;
- (vii) Of the effective date of the intended action;
- (viii) Of the reason(s) for the intended action;
- (ix) Of the specific regulations that support, or the change in federal or state law that requires the action;
- (x) Where applicable, an explanation of the circumstances under which benefits may be continued if a hearing is requested pursuant to 42 C.F.R. § 431.231.
(b) providers. The Department shall notify a provider of the right to a hearing following the request for reconsideration as specified in Chapter 16 at the time of the notice of adverse action, except when issuing a notice of claims payment or denial. A provider shall be notified of the right to request reconsideration and a hearing involving claims at the time the provider executes a provider agreement. Except as otherwise specified in this Chapter, notice shall be in writing and shall include: - (i) A statement of the intended action;
- (ii) The effective date of the intended action;
- (iii) The reason(s) for the intended action;
- (iv) The specific regulations that support, or the change in federal or state law that requires the action;
- (v) The provider's right to request reconsideration and subsequently a hearing; and
- (vi) The right to representation by a lawyer admitted to practice in Wyoming.