Haw. Code R. § 17-1703.1-4 - Action on request for hearing

(a) An individual shall submit a hearing request:

(1) By telephone;

(2) Via mail;

(3) In person; or

(4) Through other commonly available electronic means.

(b) The Med-QUEST Division must receive a hearing request within ninety (90) calendar days of the date of the notice for:

(1) Eligibility related decisions;

(2) Fee-for-service program coverage decisions; and

(3) Managed care health plan coverage decisions after completion of the managed care health plan's grievance and appeals process.

If the ninetieth (90^th) day falls on a weekend or holiday, the ninetieth day shall then be the first working day following the weekend or holiday.

(c) Upon receipt by the hearing office, the request shall be date stamped and immediately forwarded to the Med-QUEST Division to:

(1) Deternline whether the request was received within the period specified in this section;

(2) Enter the individual's name, case number, and date received;

(3) Verify the authority of a court appointed guardian filing on behalf of an individual through appropriate court documents.

(d) If the hearing request was not filed within ninety (90) calendar days of the date the notice was sent to the individual as described in (b), the request shall be denied and the department shall send a notice of denial to the individual.

(e) If an individual denied eligibility for Medicaid by the department files an appeal with the Health Insurance Exchange that appeal shall be treated as a request for hearing under this section.

(f) When the requirements specified in section 17-1703.1-5 are met, the department shall reinstate or continue assistance.

Notes

Haw. Code R. § 17-1703.1-4

[Eff 09/30/13] (Auth: HRS § 346-14(9); 42 C.F.R. §§431.221, 431.230, 431.231) (Imp: HRS § 346-12; 42 C.F.R. §§431.221, 431.230, 431.231)