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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 100 – General Provisions P a g e | 24 Timely Request for Continuation of Benefits To determine if the request for continuation of benefits is timely, the request must be received by the regional office within 15-days from the notice date. This 15-day period includes the 10-day adverse action period plus 5 days mailing time. Any hearing requested or dated after this period will not be accepted as a timely request for continuation of benefits, unless the individual presents valid evidence to support that the notice was not received within the 5-day mailing time. Continuation of Benefits When Local Decision is Adverse The recipient may request a state hearing if the local hearing is adverse. If benefits have been continued pending the local hearing, then benefits will continue pending a state hearing decision provided the request for the state hearing is made within 15 days of the date on the Notice of Local Hearing Decision. Local and state hearing procedures are discussed later in this section. Agency Action Upheld in Final Hearing Decision When the final hearing decision is adverse to the recipient, the specialist will terminate or reduce the continued benefits using the original reason for the adverse action. The supervisor will waive notice at authorization since a second Notice of Adverse Action is not required. In addition, the Division of Medicaid has the right to initiate recovery procedures against the recipient to recoup the cost of any medical services furnished the recipient under Medicaid and CHIP premiums paid by DOM on behalf of CHIP children, to the extent they were furnished solely based on the provision for continuation of benefits. 100.04.04 PREPARATION OF THE HEARING RECORD A local hearing record is not needed since an applicant or recipient or his representative is entitled to examine the entire case record prior to or during the hearing; however, the regional office is responsible for preparing the hearing record to be used at a state hearing. The state hearing folder must be electronically submitted to the Office of Administrative Appeals in the Central Office no later than five (5) Effective Month: July 2025