64.13 Appeal of Medicaid

Official source

If an individual subject to a premium appeals a decision by AHS that ends their Medicaid eligibility, reduces their benefits or services, or increases the amount of their Medicaid premium, the individual must continue to pay the premium amount in effect prior to the decision that resulted in their appeal in order to have their Medicaid coverage continue pending the outcome of their appeal. (b) AHS may recover from the individual the difference between the premium level that would have become effective had the individual not appealed AHS’s decision and the premium level actually paid during the fair hearing period when the individual withdraws the fair hearing request before the decision is made or following a final disposition of the matter in favor of AHS. [Reserved] (01/15/2019, GCR 18-064) Presumptive Medicaid eligibility determined by hospitals104 (01/01/2018, GCR 17-048)

loading…

64.13 Appeal of Medicaid

Official source

If an individual subject to a premium appeals a decision by AHS that ends their Medicaid eligibility, reduces their benefits or services, or increases the amount of their Medicaid premium, the individual must continue to pay the premium amount in effect prior to the decision that resulted in their appeal in order to have their Medicaid coverage continue pending the outcome of their appeal. (b) AHS may recover from the individual the difference between the premium level that would have become effective had the individual not appealed AHS’s decision and the premium level actually paid during the fair hearing period when the individual withdraws the fair hearing request before the decision is made or following a final disposition of the matter in favor of AHS. [Reserved] (01/15/2019, GCR 18-064) Presumptive Medicaid eligibility determined by hospitals104 (01/01/2018, GCR 17-048)