Iowa Admin. Code r. 441-7.17 - [Effective 3/26/2025] Continuation and reinstatement of benefits
(1)
Programs for which no federal or
state law applies. For all assistance programs for which there is no
contravening federal or state law, benefits or services shall not be suspended,
reduced, restricted, or discontinued, nor shall a license, registration,
certification, approval, or accreditation be revoked or other adverse action
taken pending a final decision when:
a. An
appeal is filed before the effective date of the intended action; or
b. The appellant requests a hearing within
ten days of receipt of a notice to suspend, reduce, restrict, or discontinue
benefits or services. The date on which the notice is received is considered to
be five days after the date on the notice unless the appellant shows the notice
was not received within the five-day period.
(2)
Sole issue is state or federal
law or policy. Benefits or services continued pursuant to subrule
7.17(1) may be suspended, reduced, restricted, or discontinued if the presiding
officer determines at the contested case hearing that the sole issue is one of
state or federal law or policy and the department has notified the enrollee in
writing that services are to be suspended, reduced, restricted, or discontinued
pending the proposed decision.
(3)
Recoup cost of services or benefits. The department or managed
care organization may recoup the cost of benefits or services provided pursuant
to this chapter if the adverse action appealed from is affirmed, consistent
with state and federal law.
Notes
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