Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) The
Exchange shall provide notice of appeal procedures at the time that the:
(1) Applicant submits an application;
and
(2) Notice of eligibility
determination and redetermination is sent in accordance with Sections
6476(h),
6496(h)(2), or
6498(j)(2) of Article
5 of this chapter.
(b) Notices
described in subdivision (a) of this section shall comply with the general standards
for Exchange notices specified in Section
6454 of Article 4 of this chapter and
shall contain:
(1) An explanation of the applicant
or enrollee's appeal rights under this Article;
(2) A description of the procedures by which the
applicant or enrollee may request an appeal, including an expedited
appeal;
(3) Information on the
applicant's or enrollee's right to represent themselves, or to be represented by
legal counsel or another representative;
(4) Information on how to obtain a legal aid
referral or free legal help;
(5) An
explanation that all hearings shall be conducted by telephone, video conference, or
in person, in accordance with the California Department of Social Services' Manual
of Policies and Procedures Section 22-045;
(6) An explanation of the circumstances under
which the appellant's eligibility may be maintained or reinstated pending an appeal
decision, as provided in Section
6608; and
(7) An explanation that an appeal decision for one
household member may result in a change in eligibility for other household members
and that such a change shall be handled as a redetermination of eligibility for all
household members in accordance with the standards specified in Sections
6472 and
6474 of Article 5 of this
chapter.
Note: Authority cited: Section 100504, Government Code.
Reference: Sections 100503 and 100506, Government Code; and
45 CFR Section
155.515.
Note: Authority cited: Section
100504,
Government Code. Reference: Sections
100503 and
100506,
Government Code; and 45 CFR
Section
155.515.
