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Child Care Assistance Program Policy Manual Issued 07/2023 Effect of appeal decisions 15.18 Family appeals When a family chooses not to receive child care assistance pending an appeal and then wins the appeal, reinstate the family’s eligibility back to the date of termination. Payment to an eligible provider for child care expenses incurred pending the appeal are able to be made retroactively. However, see Chapter 9.1 (Child Care Authorizations) for information about the earliest date care can be paid if a provider provided care without receiving a Service Authorization and billing form. When a family who continues to receive benefits during the appeal process loses an appeal, send a 15-day notice of termination or reduction in benefits to the family and the child care provider. Send the notice as soon as possible after the appeal decision has been received to lessen any family overpayment. Note: Due to MEC2 functionality, eligible results may continue to generate when the family is actually ineligible. Contact your Policy Specialist if assistance is needed to close the case. If the appeal decision finds the family to be ineligible or that the family received more child care assistance benefits than they were eligible to receive, calculate the amount(s) that were determined overpaid and assess an overpayment. See Chapter 14.6 (Amount of overpayment) to determine when to assess an overpayment. Provider appeals Fair hearings Human Services Judge reverses an action following a fair hearing, and the provider chose to continue receiving payments pending appeal If a provider chose to continue receiving benefits pending appeal, and it wins its appeal, no further action is needed. See Chapter 15.15 (Continuation of benefits) for information about when a provider could choose to continue receiving payments pending appeal. For example, no action is needed if: • A provider’s registration was set to close due to failure to complete the registration process; • The provider appealed timely and chose to keep its registration open continue receiving payments pending appeal; AND • A Human Services Judge reverses the agency’s action to close the registration following a fair hearing. Human Services Judge reverses an action or reduces an overpayment that already taken effect If a Human Services Judge reverses or reduces an overpayment that has been partially or fully collected: • Follow procedures in the MEC² User Manual titled Provider – Provider appeals overpayment reversed. • Refund the provider. Contact your Policy Specialist if you need assistance. NOTE: Recovery and recoupment of an overpayment must continue pending appeal. A provider cannot request that recoupment stop pending appeal, even if the provider appeals timely. See Chapter 15.15 (Continuation of Benefits).