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29.1.3 Notice of Denial Any notice of denial of BC+ eligibility for an individual or the household must include: • The month(s) that were denied and which individuals were determined ineligible • The reason(s) for the denial, including citations to the law or policy that supports the action • An explanation of the right to a fair hearing and how to request one 29.1.4 Notice of Adverse Action An adverse action is a change that will stop or reduce benefits or increase cost sharing. Members have the right to adequate and timely notice of an adverse action. 29.1.4.1 Adequate Notice of Adverse Action To be “adequate,” a notice of an adverse action must include the following: • A statement describing the intended action • The reason(s) for the intended action, including a citation to the law, regulation, rule, or policy that supports or requires the action • An explanation of the right to a fair hearing and how to request one • A statement on the availability of free representation • A statement that if a hearing is requested before the action's effective date, benefits will continue until the hearing decision is made • A statement that the member may have to repay any benefits continued during the appeal if the hearing decision isn't in their favor or they abandon or withdraw the hearing request • The telephone number and the name of the agency to contact for more information 29.1.4.2 Timely Notice of Adverse Action Timely notice must be provided at least 10 days before the effective date of any intended adverse action unless one or more of the following circumstances apply: • Factual information confirms a recipient or payee's death and there is no relative to take their place as primary person • A clear, written statement initiated and signed by the member is submitted stating they no longer wish to receive benefits • The member has applied for and is receiving benefits from another state

This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 06/20/2026 29.2 Fair Hearings Applicants and members have the right to a fair hearing, timely case decisions, and accurate notices of decision. Hearings are conducted by the Wisconsin Department of Administration, Division of Hearings and Appeals (DHA) for BadgerCare Plus and Family Planning Only Services (FPOS). Hearings serve to: 1. Interpret the program to applicants and members who disagree with the agency’s action.