Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 101 - Coverage Groups and Processing Applications and Reviews Redetermination Processes
Chapter 9 - Authorizing a Nursing Facility Per-Diem Payment for a Beneficiary Eligible in a Non-Institutional Category
Rule 23-101-9.3 - Adverse Action
Universal Citation: MS Code of Rules 23-101-9.3
Current through September 24, 2024
A. Advance notice of an adverse action is generally required, if the eligibility decision results in:
1. Termination of benefits;
2. Conversion to a reduced services coverage
group;
3. Increase in the amount of
patient liability; and
4.
Termination of a nursing facility vendor payment.
B. During the advance notice period, the recipient is allowed at least ten days notice before the date of the action. During this time, the recipient can fully comply with unmet redetermination requirements, provide information or verification that will alter the decision to terminate or reduce benefits, or request a Fair Hearing with continued benefits.
42 CFR §431.211 (Rev. 1986).
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