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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 100 – General Provisions P a g e | 12 100.04 ELIGIBILITY APPEALS AND FAIR HEARINGS At the time of any action affecting an applicant or recipient’s claim for assistance, the applicant or recipient or his representative (collectively referred to below as the “individual”) must be: • Informed of his right to a fair hearing and right to request an expedited fair hearing. • Notified of the methods by which he may obtain a hearing. • Informed of his right to represent himself at the hearing or to be represented by an authorized person such as an attorney, relative, friend or other spokesperson. • Notified of the time frames in which the agency must take final administrative action. The agency must grant the opportunity for a fair hearing to any individual who requests it because his claim for medical assistance is denied or not acted upon with reasonable promptness or because he believes that the agency has taken an action erroneously. Fair hearings must be accessible to individuals who are limited English proficient and to individuals with disabilities. A hearing request made in connection with a rebuttal prior to any adverse action being taken will not be accepted. NOTE: The agency need not grant a hearing when the sole issue is a federal or state law requiring an automatic change which adversely affects some or all recipients. Notification Regarding Appeal Rights If an interview is conducted, the right to appeal must be discussed with the individual. In addition, individuals are notified of appeal rights by statements included on the ABD and MAGI application forms and on all notices. A hearings pamphlet is included with adverse action notices informing individuals of the right to appeal and other information about the hearings process. These pamphlets are also available for distribution in regional offices and published on Division of Medicaid website. Effective Month: July 2025