Page 149

Page 2 of 3 § 10:69-6.3 Responsibilities of the CSSA in processing hearing requests 5. Contacting the applicant/beneficiary or his or her legal or authorized representative not less than two days prior to a hearing to confirm attendance and arranging for transportation by agency staff and vehicles or otherwise at agency expense when no other reasonable means of transportation is available; 6. Submitting special reports on hearing requests prior to the hearing date, when requested by BARA; 7. Submitting reports on implementation of fair hearing decisions as soon as such action is taken when requested; and 8. Serving as the single individual in the CSSA to be contacted regarding matters relating to hearings and the monitoring system. (f) The CSSA is responsible to inform the applicant/beneficiary who is requesting a hearing and elects to receive continued Medicaid that the ALJ may find him or her not entitled to all or a portion of the Medicaid coverage received during the pendency of the hearing and that, in such event, repayment may be required of the amount of benefits received from the effective date of the proposed adverse action to the date of the scheduled hearing. 1. The beneficiary shall also be advised that if he or she elects not to receive continued Medicaid coverage and the hearing decision is favorable to the client, Medicaid coverage shall be reinstated retroactive to when it was terminated. 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). Section was "Responsibilities of the CBOSS in processing hearing requests". In the introductory paragraph of (e), and in (e)2, (e)8, and (f), substituted "CWA" for "CBOSS"; in the introductory paragraph of (e)1, substituted "Administrative Review and Appeals (BARA)" for "Legal and Regulatory Liaison (BLRL)"; in (e)2, substituted "BARA" for "BLRL"; and in (e)6, substituted "BARA" for "OEP or BLRL". Annotations Notes Chapter Notes Case Notes A single mother who sought a fair hearing and a continuance following a decision by a county human services agency that terminated her Medicaid benefits effective December 1, 2011 was not entitled to an order relieving her of the obligation, imposed by N.J.A.C. 10:69-6.3(c), to repay $ 1,881, which was the overpayment that she thereafter was found to have received. The mother failed to show that she was entitled to relief from her repayment obligation under either of the exceptions in N.J.A.C. 10:69-9.23(g). Nor was the fact that the administrative law judge had found in her favor initially a factor that could be considered in determining whether she was required to repay the funds at issue. L.R. v. Gloucester Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 768-14, 2014 N.J. AGEN LEXIS 268, Initial Decision (May 16, 2014).