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Missouri Application for the State Children’s Health Insurance Program Effective Date: 09/01/2007 Approval Date: 09/28/2007

Prior Approval Date: - 52 - enrollee took to subsequently file for a State fair hearing) or the date the member filed for direct access to a State fair hearing. • Expedited resolution (if the appeal was heard first through the MCO appeal process): within three working days from the state agency’s receipt of a hearing request for a denial of a service that: • Meets the criteria for an expedited appeal process but was not resolved using the MCOs expedited appeal timeframes, or • Was resolved wholly or partially adversely to the member using the MCOs expedited appeal timeframes. Expedited resolution (if the appeal was made directly to the State fair hearing process without accessing the MCO appeal process): within three working days from the state agency’s receipt of a hearing request for a denial of a service that meets the criteria for an expedited appeal process. Premium Assistance Programs 12.2 If providing coverage through a group health plan that does not meet the requirements of 42 CFR part 457.1120, please describe how the State will assure that applicants and enrollees have the option to obtain health benefits coverage other than through the group health plan at initial enrollment and at each redetermination of eligibility.