Page 1

COMBINED MEDICAID 103-3 Client Rights and Responsibilities Supersedes: FMA 103-3 (07/01/05) Reference: 42 CFR 435.911, .912; ARM 37.82.101 Overview: Eligibility staff inform all Medicaid clients of their rights and responsibilities. Information is provided verbally or in writing, as appropriate, at the time of application and redetermination. CLIENT RIGHTS: Each Medicaid client has the right to: • apply for assistance without delay; • have someone of his or her choice assist them with application and redetermination; • ask about coverage, eligibility requirements, program scope, and related services, and to receive a response in writing and verbally; • be informed of the consequences for failure to comply with all nonfinancial and financial eligibility requirements; • be determined eligible or ineligible within 45 days (or 90 days for applicants who apply for Medicaid on the basis of disability) of application unless the county is unable to make a determination because of circumstances beyond the agency’s control; • request to receive an extension to provide required information; • receive timely and/or adequate written notice of denial, reduction or termination of assistance; • be informed of his or her rights to a fair hearing if he or she feels the case has not received proper treatment; • have confidentiality in his or her relationship with the agency; • tell the story in his or her own way; • continue to be responsible for him/herself; • claim good cause for refusal to cooperate in child support collection; • claim good cause for not providing certain information; • be informed of the services of Child Support Enforcement; Family Planning; and Early and Periodic Screening, Diagnosis and Treatment (EPSDT), as appropriate; and • not be discriminated against on the grounds of race, color, sex, culture, age, creed, marital status, physical disability, mental disability or national origin.