N.M. Admin. Code § 8.314.7.20 - RIGHT TO AN HSD ADMINISTRATIVE HEARING
A. The human services department/medical
assistance division (HSD/MAD) must grant an opportunity for an administrative
hearing as described in this section in the following circumstances and
pursuant to
42 CFR Section
431.220(a)(1), Section
27-3-3 NMSA 1978 and 8.352.2 NMAC Recipient Hearings:
(1) when a supports waiver applicant has been
determined not to meet the LOC requirement for waiver services;
(2) when a supports waiver applicant has not
been given the choice of HCBS as alternative to institutional care;
(3) when a supports waiver applicant is
denied the services of their choice or the provider of their choice;
(4) when a supports waiver recipient's
services are denied, suspended, reduced or terminated;
(5) when a supports waiver recipient has been
involuntarily terminated from the program; or
(6) when a supports waiver recipient's
request for a budget adjustment has been denied.
B. DOH and its counsel, if necessary, shall
participate in any fair hearing involving an eligible recipient. HSD/MAD, and
its counsel, if necessary, may participate in fair hearings.
Notes
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