Beneficiary Appeals. A. Right to Appeal Beneficiaries may request an internal MCE appeal of an MCE action, and a subsequent fair hearing before the Human Services Board. MCE actions are considered preliminary decisions subject to appeal. If no appeal is filed within the 90-day time frame set out in these rules, the original or reconsidered decision is considered the final MCE decision. If an appeal is filed, the decision rendered as a result of the appeal is the final MCE decision. Nothing in the MCE appeals procedures should preclude reconsideration of a decision by the MCE staff member or entity that made the original decision. A request for reconsideration may be made orally or in writing by the beneficiary, provider or designated representative. A request may be accompanied by any additional information that supplements or clarifies material that was previously submitted and is likely to materially affect the decision. A request for reconsideration does not suspend the 90-day time frame for filing of appeals. In addition, a request for reconsideration does not suspend the 45-day time frame for an MCE to make a decision on an appeal.
Beneficiary Appeals
