Expedited Resolution. i. If the appeal was heard first through the Contractor appeal process DHCS shall reach a decision within 3 working days from agency receipt of a hearing request for a denial of a service that meets the criteria for an expedited appeal process but was not resolved using the Contractor’s expedited appeal timeframes, or ii. Was resolved wholly or partially adversely to the beneficiary using the Contractor’s expedited appeal timeframes. iii. If the appeal was made directly to the State Fair Hearing process without accessing the Contractor’s appeal process, DHCS shall reach a decision as expeditiously as the beneficiary’s health condition requires, but no later than 3 working days from state receipt of a hearing request for a denial of a service that meets the criteria for an expedited resolution.
Appears in 9 contracts
Samples: Standard Agreement, Standard Agreement, Intergovernmental Agreement
