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N.J.A.C. 10:69-5.11 This file includes all Regulations adopted and published through the New Jersey Register, Vol. 57 No. 12, June 16, 2025 NJ - New Jersey Administrative Code > TITLE 10. HUMAN SERVICES > CHAPTER 69. AFDC-RELATED MEDICAID > SUBCHAPTER 5. CONTINUING ELIGIBILITY IN AFDC-RELATED MEDICAID § 10:69-5.11 Notice of agency decision (a) Each applicant shall receive timely and adequate written notice of any change in Medicaid eligibility status in accordance with N.J.A.C. 10:69-6. (b) If the notice of intention to terminate Medicaid eligibility is related to identification of possible fraud, beneficiaries are entitled to timely notice as defined at N.J.A.C. 10:69-6.1. 1. Seven days notice shall be considered timely when, in the judgment of the CSSA director, there is substantiated evidence that the client is receiving Medicaid coverage through willful fraud (see N.J.A.C. 10:69-9.15 through 9.18). History HISTORY: Amended by R.2017 d.209, effective December 4, 2017. See: 49 N.J.R. 1789(a), 49 N.J.R. 3729(a). Rewrote (b). Annotations Notes Chapter Notes Case Notes Medicaid recipient who failed to timely notify the county social services board that she had moved from Address 1 to Address 2 thereby failed to meet her obligations to provide the agency with accurate and timely information as required for continued eligibility. That being so, her claim that she did not receive timely notice of the agency's intention to terminate her benefits had no merit and she was not entitled to an award of retroactive benefits. S.G. v. Hudson Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 01622-17, 2017 N.J. AGEN LEXIS 162, Initial Decision (March 20, 2017). NEW JERSEY ADMINISTRATIVE CODE Copyright © 2025 by the New Jersey Office of Administrative Law