Current through Register Vol. 50, No. 9, September 20, 2024
A. Informal
Review and Administrative Appeal of Agency Decision. Through the informal
review and administrative process, any authorized representative may request
that the agency review and reconsider any or all aspects of a particular
recovery matter in which he/she is involved.
1. If the authorized representative disagrees
with the estimated amount and/or the basis for the estate recovery and is
requesting an undue hardship waiver, the authorized representative must submit
the following information to the department within 30 days of receipt of the
estate recovery notice:
a. a written request
for an informal review which states the basis for the disagreement(s) along
with all of the supporting documentation to substantiate the disagreement;
or
b. a completed notarized
hardship waiver application along with all of the documentation needed to
support the request for a hardship waiver.
2. If the authorized representative wishes to
obtain a copy of the claims history upon which the recovery amount is based,
the HIPPA authorization form enclosed with the recovery notice must be
completed and returned to the department within five days of receipt of the
recovery notice.
3. The written
request for an informal review and/or hardship waiver must be post marked or
delivered to the department on or before the 30th day from receipt of the
estate recovery notice.
4. If the
written request for an informal review and/or the completed notarized hardship
waiver application along with all supporting documentation is not received
within the 30 day period, the action set out in the estate recovery notice
shall be the final agency decision.
5. If the written request for an informal
review and/or the completed notarized hardship waiver application along with
all supporting documentation is received timely, the department shall conduct
an informal review of the estate recovery decision.
a. The informal review may be conducted
in-person, via phone or other electronic media and/or through a review of the
documentation.
b. Following the
informal review, the department will issue a written notice to the authorized
representative of the reason(s) for its findings and the amount owed by the
estate.
B.
The authorized representative shall have 30 days from the date of mailing of
the estate recovery notice to seek an administrative appeal with the
appropriate state administrative tribunal.
C. In addition to the provisions of this
Section, any aggrieved party shall have the administrative appeal rights
available pursuant to the Administrative Procedure Act.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
