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MEDICAL SERVICES POLICY MANUAL,SECTION L

L 100 Administrative Hearings

L-100 Administrative Hearings

MS Manual 06/01/25 The purpose of the administrative hearing process is to provide a procedure for DHS clients to appeal: 1. The denial of Medical Assistance, 2. The failure of the Division of County Operations (DCO) to process the application within specified timeframes, 3. When a petitioner disagrees with any DCO action resulting in suspension, reduction or discontinuance of assistance, or 4. When an Institutionalized Spouse (IS) or Community Souse (CS) is dissatisfied with the determination of: a. The CS’s monthly income allowance, b. The amount of monthly income otherwise available to the CS, c. The computation of the spousal share of resources, or d. The attribution of resources or the CS’s resource allowance. A hearing will not be granted when either state or federal law requires a reduction in medical assistance. A request for a hearing must be received in the Office of Appeals and Hearings (OAH) within 35 days of the Notice of Action date.

L-110 Appeal Process MS Manual 01/01/14 A petitioner or his/her designated representative may request a hearing by: 1. Completing the reverse side of the Notice of Action. 2. Making the request by letter to OAH. 3. Completing, with assistance from DCO staff as needed, a DHS-1200, Appeal for a Hearing Form. The county office will assist the petitioner whenever necessary; however, the primary responsibility for providing all information relevant to the administrative appeal rests with the petitioner or his/her representative. DCO will immediately forward requests for hearings to OAH.