Common use of BENEFICIARY’S RIGHTS Clause in Contracts

BENEFICIARY’S RIGHTS. Contractor shall inform Medi-Cal Beneficiaries of their following rights: • Beneficiary grievance, appeal, and fair hearing procedures and timeframes as specified in 42 CFR 438.400 through 42 CFR 438.424. • The beneficiary’s right to file grievances and appeals and the requirements and timeframes for filing. • The availability of assistance to the beneficiary with filing grievances and appeals. • The beneficiary’s right to request a State fair hearing after Contractor has made a determination on an enrollee's appeal, which is adverse to the beneficiary. • The beneficiary’s right to request continuation of benefits that Contractor seeks to reduce or terminate during an appeal or state fair hearing filing, if filed within the allowable timeframes, although the beneficiary may be liable for the cost of any continued benefits while the appeal or state fair hearing is pending if the final decision is adverse to the beneficiary.

BENEFICIARY’S RIGHTS. Contractor shall inform Medi-Cal Beneficiaries of their following rights: • Beneficiary grievance, appeal, and fair hearing procedures and timeframes as specified in 42 CFR 438.400 through 42 CFR 438.424. • The beneficiary’s right to file grievances and appeals and the requirements and timeframes for filing. • The availability of assistance to the beneficiary with filing grievances and appeals. • The beneficiary’s right to request a State fair hearing after the Contractor has made a determination on an enrollee's appeal, which is adverse to the beneficiary. • The beneficiary’s right to request continuation of benefits that the Contractor seeks to reduce or terminate during an appeal or state fair hearing filing, if filed within the allowable timeframes, although the beneficiary may be liable for the cost of any continued benefits while the appeal or state fair hearing is pending if the final decision is adverse to the beneficiary.