Page 124

(a) Timely notice need not be provided in the following circumstances: (i) The recipient who was the sole member of the assistance unit dies; (ii) The recipient indicates in writing that he no longer wishes assistance, and that he understands that termination of assistance will be the consequence of that written statement;

(iii) The recipient gives information which requires termination of assistance and indicates in writing that he understands that termination of assistance will be the consequence of supplying the information;

(iv) The recipient is admitted to an institution where he is ineligible under the Program for further services;

(v) The recipient's whereabouts are unknown, as evidenced by the return of unforwardable mail directed to him; or

(vi) The recipient is accepted for Medicaid services in another jurisdiction, state, territory, or commonwealth.

(b) Adequate notice shall be provided by the local department of social services upon receipt of acceptable written verification, but no later than the date of action.

(4) If a recipient files a request for a hearing within 10 days from the date that the notice of action was mailed, the recipient's benefits shall be continued at their previous level until a decision is rendered after the hearing or the request for a hearing is dismissed by the hearing officer.

(5) A request for a hearing shall be dismissed if the hearing officer determines that the sole issue appealed is one of federal or State law. The recipient shall be notified in writing that eligibility for assistance is being terminated or benefits are being reduced. C. Recovery of Medical Assistance Expenditures Made on Behalf of Ineligible Persons. (1) The local department of social services shall refer to the Medical Care Compliance Administration on a form designated by the Department, all cases in which:

(a) An otherwise ineligible recipient is granted Medical Assistance coverage pending a hearing decision; and

(b) The hearing officer subsequently affirms the decision made by the local department of social services.

(2) The Medical Care Compliance Administration shall institute procedures to recover the cost of any expenditures made on behalf of a recipient in cases identified in §C(1) of this regulation. This provision may not apply to a person who requested a hearing and extended benefits resulting from a bona fide belief that the local department of social services has taken an adverse action erroneously.