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N.J.A.C. 10:69-6.3 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 6. COMPLAINTS, HEARINGS, AND ADMINISTRATIVE REVIEWS § 10:69-6.3 Responsibilities of the CSSA in processing hearing requests (a) Upon receipt of a timely request for a fair hearing, Medicaid coverage shall be continued until a written decision is rendered, unless: 1. A determination is made at the hearing by the ALJ that the sole issue is one of State or Federal law or policy, or change in State or Federal law, and not one of disputed facts; or 2. A change occurs which further affects beneficiary's eligibility while the first hearing decision is pending and the beneficiary fails to request an additional hearing after notice of this change within the time allowed. (b) In the event of either (a)1 or 2 above, the beneficiary shall be promptly notified in writing that the proposed action will be implemented after the hearing while the decision is pending. (c) Any incorrectly paid benefit resulting from continued Medicaid coverage is subject to recovery. In the event that agency action is sustained and a beneficiary has received incorrectly paid Medicaid benefit, solely due to continued eligibility, recovery shall be effected in accordance with procedures in N.J.A.C. 10:69-9.23. (d) A beneficiary may waive his or her claim to Medicaid by submitting a written statement at the time the fair hearing is requested. (e) To assure orderly and expeditious processing of complaints and hearing requests, each CSSA shall designate a liaison between the county and State Division whose duties shall include, but not be limited to: 1. Informing the Bureau of Administrative Review and Appeals (BARA) by telephone on the same day an oral or written request for a hearing is received, providing the following information: i. The case number and the applicant/beneficiary's name and address; ii. The date the request received; iii. The nature of contested action; iv. The date of action; and v. The reason for action; 2. Establishing a system to assure that every written request for a hearing received in the CSSA office is stamped with the date of receipt and forwarded to BARA within one work day of the date; 3. Reviewing incoming requests for possible corrective action prior to hearing; 4. Identifying and arranging for participation of staff individuals who are essential to a hearing, and assembling all records relevant to a hearing and arranging for an interpreter when the client is non- English speaking;