Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 610.000 - MassHealth: Fair Hearing Rules
Section 610.035 - Dismissal of a Request for a Hearing
Universal Citation: 130 MA Code of Regs 130.610
Current through Register 1531, September 27, 2024
(A) BOH will dismiss a request for a hearing when
(1)
the request is not received within the time frame specified in
130 CMR
610.015;
(2) the request is withdrawn by the
appellant;
(3) the sole issue is
one of state or federal law requiring automatic change in assistance for
classes of members;
(4) the stated
reason for the request does not constitute grounds for appeal as set forth in
130 CMR
610.032. Without limiting the generality of
the foregoing, except as provided in
130 CMR
610.032(A)(11), no provider
decision or action including, but not limited to, a provider determination
about whether or the extent to which a service is medically necessary,
constitutes an appealable action hereunder;
(5) the stated reason for the hearing request
is outside the scope of 130 CMR 610.000 as set forth in
130 CMR 610.003;
(6) BOH has conducted a hearing and issued a
decision on the same appealable action arising out of the same facts that
constitute the basis of the request;
(7) the party requesting the hearing is not
an applicant, member, or resident as defined in
130 CMR
610.004;
(8) BOH learns of an adjustment or action
that resolves all of the issues in dispute between the parties;
(9) BOH learns that the applicant or member
has passed away before or after the date of filing and there is no full
compliance with
130 CMR 610.016(B)
within ten days of a BOH request;
(10) BOH learns that the applicant or member
has passed away prior to the date of filing and scheduling of the hearing and
is not informed until the date of the hearing and there is no full compliance
with
130 CMR
610.016(B); or
(11) the appellant fails to appear at a
scheduled hearing.
(B)130 CMR 610.048(C) contains the procedure for BOH notices of dismissals and attempts to vacate such dismissals. The BOH Director may also, at his or her discretion, order a hearing scheduled to allow the appellant the opportunity to contest the dismissal.
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