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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 100 – General Provisions P a g e | 27

Effective Month: March 2019 during the hearing process. The new effective date of closure or reduced benefits must include an effective date at the end of the 15-day advance notice period allowed via DOM-351. A second Notice of Adverse Action is not required; therefore, the second eligibility notice should be waived at authorization if benefits are terminated or reduced because of the local hearing decision.

However, if a state hearing is subsequently requested within the 15-day advance notice period and continuation of benefits is applicable, the regional office will reinstate the individual’s eligibility pending the outcome of the state hearing.

100.04.07 TAKING ACTION ON THE CASE The regional office is responsible for taking any corrective action required because of a local or state hearing decision rendered in favor of the applicant or recipient or for processing the original planned action on the case which was the basis for the appeal if continuation of benefits applied pending the hearing decision.

100.04.08 STATE HEARING REQUESTED AFTER ADVERSE LOCAL DECISION As indicated, the individual has the right to appeal a local hearing decision by requesting a state hearing; however, the state hearing request must be made within 15 days of the mailing date of the DOM-351. This means the state hearing request must be received by the regional or central office on or before the 15th day after the local hearing notice is mailed. The state hearing request may be submitted to the regional or central office by mail, in-person, by fax or by other commonly accepted electronic means, such as fax, email, or online through common web portal. An original signature is not required to be a valid state hearing request. If benefits have been continued pending the local hearing decision, then benefits will continue throughout the 15-day advance notice period when the local hearing decision is adverse. If a state hearing is requested timely within the 15-day period, then benefits will continue pending the outcome of the state hearing.