Page 32

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 100 – General Provisions P a g e | 32

Effective Month: March 2019 testimony and evidence, in which case the hearing officer will submit a new recommendation to the Executive Director after the additional action has been taken. As soon as possible after the hearing officer makes a recommendation, a written decision summarizing the facts and identifying the policies and regulations which support the decision will be prepared and mailed to individual, with a copy to the regional office, Bureau Director, Deputy, and the Deputy Administrator for Eligibility. The decision letter will specify any action to be taken by the agency and any revised eligibility dates. If the decision is adverse and continuation of benefits is applicable, the individual will be notified of the new effective date of reduction or termination of benefits or services, which will be fifteen (15) days from the mailing date of the notice of decision. The decision of the Executive Director of the Division of Medicaid is final and binding. The individual is entitled to seek judicial review in a court of appropriate jurisdiction. Should the individual file an appeal the second time without a change in circumstances or agency policy, the individual will be notified in writing by the appropriate office explaining that the appeal cannot be honored. If the individual’s circumstances or agency policy have changed, the individual will be advised to file a new application.

100.04.17 REGIONAL OFFICE RESPONSIBILITIES IN THE HEARING PROCESS Each Regional Office (RO) must have a system in place to track and monitor hearing requests from the date of receipt through the final appeal decision. • Each RO must promptly identify and document all hearing requests received by the office and immediately route the request to the appropriate person in the office assigned to handle hearing requests. This person will review the case record to ensure: o The proper person is filing the request, i.e., the person with authority to act for the individual. If not, contact the appropriate person to determine if a hearing needs to be requested. o An expedited hearing request is handled appropriately, i.e., the request is granted or denied according to policy and DOM-351A is issued