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UNOFFICIAL 1703.1-10 otherwise permitted for a hearing as described in section 17-1703.1-15(a)(1) or (a)(2) would jeopardize the individual’s life or health or ability to attain, maintain or regain maximum function. (b) If the department determines that the request does meet the criteria for an expedited hearing, it must: (1) Initiate the hearing process as described in section 17-1703.1-12; and (2) All matters relating to the hearing shall be heard and disposed of as expeditiously as the individual’s health conditions requires, but no later than (3) working days after the department receives the request for an expedited hearing. (c) If the department determines that the request does not meet the criteria for an expedited hearing, it must: (1) Initiate the standard hearing process timeframe, in accordance with 17-1703.1- 15(a)(1) or (a)(2); and (2) Notify the individual orally or through an electronic notice as described in section 17-1713-6 of the denial and, if oral notification is provided, the department will follow up with a written notice within two (2) calendar days of the denial. (d) An individual enrolled in a managed care health plan shall first be required to complete that health plan’s internal expedited appeal process for any denied service. [Eff 09/30/13] (Auth: HRS §346- 14(9); 42 C.F.R. §431.224) (Imp: HRS §346- 12; 42 C.F.R. §431.224)

§17-1703.1-12 The hearing. (a) The hearing shall include consideration of: (1) Any adverse action by the department or managed care health plan which includes: (A) Failure to determine eligibility within the specific time limits of the medical assistance programs; (B) Refusal to consider a request for or failure to make a payment adjustment within time limits set by the medical assistance programs; or