N.M. Code R. § 8.354.2.9 - CLAIMANT OR THE CLAIMANT'S AUTHORIZED REPRESENTATIVE AND HSD ADMINISTRATIVE HEARING PROCESS
HSD has established a hearing process for a
A. Claimant :
(1) When an adverse action (see Subsection B
of 8.354.2.7 NMAC) is intended or taken against a MAP eligible recipient by
MAD , its UR contractor or their designee , the MAP eligible recipient may file
as a claimant to request a HSD administrative hearing.
(2) When an adverse action (see Subsection B
of 8.354.2.7 NMAC) is intended or taken against a member by his or her MCO or
its designee , the member may file as a claimant to request a HSD administrative
hearing. A member is not required to first exhaust his or her MCO appeal
process prior to filing for a HSD administrative hearing when affected by an
adverse action listed in 8.354.2.7 NMAC. Upon requesting a HSD administrative
hearing , the member is referred to as the claimant and is governed by the
remaining sections of this rule.
(3) A claimant must request a HSD
administrative hearing within 90 calendar days of the mailing of either the
notice of action or the denial for new service.
B. A claimant or the claimant 's authorized
representative may have legal counsel assist him or her during the HSD
administrative hearing process. If a claimant or the claimant's authorized
representative , MAD, its UR contractor, the MCO or their designees retains
legal counsel, that legal counsel must submit a notice of appearance to the
assigned ALJ. The ALJ will forward this notice to the MAD administrative
hearings unit (MAD AHU).
C. The
claimant or claimant 's authorized representative may also chose a relative,
friend or other spokesperson (spokesperson) to represent or assist him or her
in the HSD administrative hearing process.
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