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COMAR 10.09.24.03

371 State of Maryland Medical Assistance Manual Revised July 2012 Summary of Procedures for Fair Hearings You have the right to appeal this decision within 90 days from the date of this notice. Your request must be made in writing on a form you may obtain from your Case Manager. Please include the specific reason(s) for your appeal. If you wish, someone at the local department of social services may assist you in completing the form for filing your appeal. Bring the form to your local department of social services office, or you may mail your request for a hearing to the following address: Office of Administrative Hearings Administrative Law Building 11101 Gilroy Road Hunt Valley, Maryland 21031-1301 The hearing will be scheduled at a time and place that are convenient for you. You will be expected to be present. If for any reason you cannot be present, you must notify the Office of Administrative Hearing to reschedule the hearing or to identify the person who will attend in your place. You may represent yourself, or if you wish you may be represented by legal counsel or by a relative, friend or other person, although it is not required that someone represent you. You may bring any witnesses you desire to help you establish pertinent facts and to explain your circumstances. A reasonable number of persons from the general public may be admitted to the hearing if you so desire.

You may obtain free legal aid and help through various resources, such as the Legal Aid Bureau at 1-800-999-8904. (o) Family Planning Program Effective January 1, 2012, The DHMH has expanded the current MA Family Planning Program (FP). Medicaid will cover family planning services for low income women under the age of 51 in addition to the current postpartum women. What is Family Planning (FP) Program? Provides family planning benefits for certain low income eligible women. Applicant must be under 51 years of age, a Maryland resident, and a U.S. citizen or a qualified alien who meets all requirements for benefits. The FP is a fee- for service program and recipients will not be enrolled in a MCO‟s. FP Eligibility Criteria: A U.S. citizen or qualified alien A Maryland resident Female, under 51 years of age who; o Is not pregnant o Has not had a permanent sterilization An applicant must also have household income that does not exceed 200% of the Federal Poverty Level. Women who already have MA are not eligible for this program