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Indiana Health Coverage Program Policy Manual Chapter 4200 APPEALS AND FAIR HEARINGS Sections 4200.00.00 – 4215.00.00

Contents 4200.00.00 APPEALS AND FAIR EARINGS………………………………………………………………………………3 4205.00.00 APPEAL REQUEST..…………………………………………………………………………………………...3 4205.05.00 RIGHT TO APPEAL……………………………….……………………………………………………….….3 4205.05.05 ASSISTANCE IN EXERCISING THE RIGHT TO APPEAL…………………………………………...3 4205.10.00 APPEALABLE ACTIONS…………………………………………………………………………………….….4 4205.10.05 SPOUSAL IMPOVERISHMENT SPECIFIED APPEALABLE ISSUES (MED 1)….………..4 4205.15.00 GROUP APPEALS……………………………………………………………………………….………………4 4205.20.00 TIME LIMITS FOR REQUESTING APPEALS…….…………………………………….………….… 4 44205.25.00 RESERVED…………………………………………………………….……………………………………........4 4205.26.00 CONTINUED BENEFITS WHILE APPEAL IS PENDING……………………………………….….6 4205.27.00 FAILURE TO ISSUE NOTICE OF ADVERSE ACTION……………………………………………. 6 4205.30.00 APPEAL PROCEDURES ………………………………………………………………….……………….….6 4205.35.00 THE HEARING NOTICE…………….…………………………………………………………….…………...7 4205.40.00 REQUEST FOR CONTINUANCE FROM THE APPELLANT FOR MEDICAL ……………….7 4205.40.05 REQUEST FOR CONTINUANCE FROM THE APPELLANT FOR MICAL EVIDENCE……8 4205.40.10 REQUEST FOR CONTINUANCE FROM THE DFR……………………………………………….….8 4205.45.00 REVIEW OF ACTION BY DFR……………………………….………………………………….….……….8 4205.45.05 RESERVED…………………………………………………………………….……….……………………….……8 4205.50.00 DISPOSAL OF APPEAL WITHOUT A FAIR HEARING…………………………………….….….. 8 4205.50.05 ADJUSTING ACTION BY DFR…………………………………….……………………………….……. 8 4205.50.10 WITHDRAWAL OF APPEAL BY APPELLANT………………………………………………………...8