23 Miss. Code. R. 208-7.9 - Appeals and Hearings

A. If it is determined that a person does not meet 1915(i) eligibility criteria or if decisions made by the Department of Mental Health (DMH) result in services being denied, terminated, or reduced the /legal representative has the right to request an appeal from the DMH.

B. If the person and/or guardian/legal representative disagrees with the decision made by the DMH Executive Director a written request to appeal the decision may be made to the Executive Director of the Division of Medicaid. [Refer to Miss. Admin. Code Part 300]

C. During the appeals process, contested services must remain in place, unless the decision is made for immediate termination due to immediate or perceived danger, racial discrimination or sexual harassment by the service providers. The Targeted Case Manager is responsible for ensuring that the person continues to receive all services that were in place prior to the notice of change.

D. Providers who must be certified by DMH may appeal issues related to certification to DMH as outlined in the DMH Operational Standards and Administrative Code.

Notes

23 Miss. Code. R. 208-7.9

42 U.S.C. § 1396n; Miss. Code Ann. §§ 41-4-7, 43-13-121.

New to correspond with SPA 2013-001 (eff. 11/01/2013) eff. 04/01/2014. Amended 1/1/2017