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termination in benefits during the continued benefit period, other than the reason for why there is an appeal in the first place. The appeal, however, must continue. For Medicaid members, if there is an active appeal with continued benefits, no negative action should be taken on the case until the ALJ determination is received. For example, if a members Medicaid was closed for failure to return income, the member appeals with continued benefits, then the member later turns in income but is over the income limit, the Medicaid must remain open until the ALJ makes their determination. After the decision is released, then if it is no longer eligible, the case can be closed. Note: Continuous benefits authorized for children under 19 pending an appeal decision do not initiate or establish a new CE period. The continuous eligibility period and/or category is established or reestablished by the effective date of the member’s application decision or annual redetermination decision can include retro period; whichever is most recent. 15 4205.27.00 FAILURE TO ISSUE NOTICE OF ADVERSE ACTION If an adverse action is taken against an applicant or recipient without the required notice being issued, a notice must be sent to the applicant or recipient and authorized representative(s) immediately upon knowledge of the situation. Benefits are not reinstated/restored at this point. If an appeal of the action is received by the DFR within ten (15) days of the mailing date of the notice, benefits are to be reinstated at the level prior to the adverse action. The appeal must be received by close of business on day 10 after the date of receipt. If day 10 is a non-business day, the appeal must be received by close of business on the next FSSA business day.16 If the appellant can demonstrate that he did not receive the notice within fifteen (15) days of the mailing date, benefits must be reinstated if the appeal request is received within ten (10) days of the date the appellant demonstrated that he received the notice. 4205.30.00 APPEAL PROCEDURES All appeals filed with the DFR are to be immediately forwarded to the OHA. The DFR should inform Office of Administrative Law Proceedings if a hearing request is received from the applicant or recipient that plan to move, such as farm workers, so that the request can be expedited to enable a decision to be reached before the applicant or recipient leaves the area. 4205.35.00 THE HEARING NOTICE The Hearings and Appeals Section sends a notice acknowledging the appeal to the applicant or recipient (appellant) and the DFR.17 The notice must meet the following criteria: Includes a statement of the date, time, place, and nature of the hearing which is always conducted in the appellant's county of residency18 or via telephone Advises the appellant of the name, address, and telephone number of the person to notify in the event it is not possible for him to attend