New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-M - Former Division of Mental Health and Developmental Services
Chapter He-M 500 - DEVELOPMENTAL SERVICES
Part He-M 520 - CHILDREN'S SPECIAL MEDICAL SERVICES
Section He-M 520.08 - Appeals

Universal Citation: NH Admin Rules He-M 520.08

Current through Register No. 40, October 3, 2024

(a) Pursuant to He-M 202, an applicant, recipient, parent, or guardian may request to informally resolve any disagreement with SMS, or, within 30 business days of an SMS decision, she or he may choose to file a formal appeal. Any determination, action, or inaction by SMS may be appealed.

(b) If informal resolution is requested, the administrator shall meet and review with the applicant, recipient, parent, or guardian the financial status or medical condition of the applicant or recipient that pertains to the applicant's or recipient's eligibility.

(c) SMS shall notify the applicant, recipient, parent or guardian of the findings of the review, in writing, within 15 business days of a case review conference.

(d) Formal appeals shall be submitted, in writing, to the bureau administrator in care of the bureau's office of client and legal services. An exception shall be that appeals may be filed verbally if the individual is unable to convey the appeal in writing.

(e) If a hearing is requested, the following actions shall occur:

(1) Services and payments shall be continued as a consequence of a request for a hearing until a decision has been made; and

(2) If SMS's decision is upheld, funding shall cease 60 days from the date of the denial letter or 30 days from the hearing decision, whichever is later.

#9748-A, eff 7-1-10

The amended version of this section by New Hampshire Register Volume 39, Number 02, eff.12/28/2018 is not yet available.

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