Section 4-6 - Time of Notice (a) Applicants. The Department shall mail notice of adverse actions within the timeframe specified in Department rules.
(b) Clients. The Department shall mail notice of adverse action at least ten (10) days before the effective date, except: - (i) The Department may shorten the period of advance notice to five (5) days before the effective date if the Department has facts indicating that action should be taken because of probable fraud by the client, and the facts have been verified, if possible, through secondary sources.
- (ii) The Department may mail notice not later than the effective date if:
- (A) The Department has factual information confirming the death of a client;
- (B) The Department receives a clear written statement signed by a client that:
- (I) The client no longer wishes services; or
- (II) Gives information that requires termination or reduction of services and indicates that the client understands that this will be the result of supplying that information;
- (C) The client has been admitted to an institution where he or she is ineligible under the plan for further services.
- (D) The client's whereabouts are unknown and the post office returns agency mail indicating no forwarding address;
- (E) The Department establishes that the client has been accepted for benefits by another local jurisdiction, state, territory or commonwealth;
- (F) A change in the level of medical care is prescribed by the client's physician; or
- (G) The notice involves an adverse determination made with regard to preadmission screening requirements for persons with mental illness or intellectual disability.
(c) providers. - (i) Notice of denial or reduction of payments. The Department shall notify a provider of the denial or reduction of payments as soon as practicable after such denial or reduction.
- (ii) Notice of termination, suspension or sanction. The Department shall notify a provider of the termination, suspension or other sanction on or before the effective date, except as otherwise specified in the Department's Medicaid rules.