Benefits Pending a Fair Hearing 400-28-155-20

(Revised 10/1/20 ML #3574)

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NDAC 75-02-01.3-13

If an application was denied and client requested a fair hearing , the denial remains in effect.

If a recipient appeals a decision within 10 days from the date of the notice of adverse action, the case remains open and payment is issued at the same level through the end of the current eligibility period. If the case has already closed, the case would need to be reverted to open.

If a fair hearing has not been heard at the time the caretaker is due for a review, the review is completed and a new Co-pay , State Rate , and Level of Care is established for the new eligibility period.

If the client disagrees with the new Co-pay, State Rate, payment amount, and Level of Care, that is a separate appealable issue.

If the caretaker is appealing an overpayment within 10 days from the date of the notice of the overpayment, the overpayment will be suspended until the outcome of the appeal has been determined.

If the caretaker is appealing a payment amount within 10 days from the date of the notice of adverse action, the caretaker’s Co-pay, State Maximum Monthly Share and Level of Care remain at the same level that was in effect at the time of the appeal.