State Fair Hearings Sample Clauses

State Fair Hearings. ‌ (a) AHS shall alone be responsible for developing and implementing State Fair Hearing rules and policies. (b) AHS shall be responsible for ensuring that State Fair Hearing rules, policies, and practices comply with the federal statutes and regulations, including provisions applicable to DVHA operations. (c) In most cases, the beneficiaries must exhaust the internal appeal prior to making a State Fair Hearing request, unless exhaustion is deemed as set forth above in Section 2.18(b)(iii). A beneficiary who seeks review of a service not subject to the internal appeal process pursuant to HCAE 8.100.1 does not have to exhaust the internal appeal process. (d) Beneficiaries have the right to file requests for a State Fair Hearing related to eligibility and premium determinations. With the written consent of the beneficiary, a provider or an authorized representative may request a State Fair Hearing on behalf of the beneficiary. The beneficiary, his/her representative, or the representative of a deceased beneficiary’s estate shall be parties to a State Fair Hearing. (e) AHS shall retain responsibility for representing the State in any fair hearings pertaining to such eligibility and premium determinations. Hearing descriptions must be included in beneficiary and provider information within the contract. (f) AHS will accept a timely request for a State Fair Hearing from a beneficiary and will process the request without delay. A timely request for a State fair hearing means that a beneficiary has requested the State Fair Hearing: within 120 days of the date the notice of resolution of the internal appeal was mailed to the beneficiary by DVHA (mailing is the postmark date which is considered one business day after the date of the notice), or, if there was no internal appeal (for those services for which the internal appeal process does not apply), then within 120 days after the mailing of the notice of adverse benefit determination. DocuSign Envelope ID: F73EF454-508D-44AC-ABD8-2A528194331A (g) Beneficiaries also have the right to file a request for an expedited State Fair Hearing after exhausting the internal appeal process for expedited appeals, unless exhaustion is deemed as set forth above in Section 2.18(b)(iii). (h) Expedited State Fair Hearing shall be resolved as expeditiously as the beneficiary’s health condition requires, but no later than 3 working days after the agency (the Human Services Board) received the case record and information for an appeal t...
Sample 1
AutoNDA by SimpleDocs
State Fair Hearings. 1. To advise Enrollees that they may request a State fair hearing within 120 days of an MCO appeal resolution using the process specified in COMAR 10.01.04.
Sample 1
State Fair Hearings. 13.1.4.1 The Contractor shall participate in State Fair Hearings as directed by EOHHS. Hearing shall be conducted in accordance with guidelines, rules, and regulations established by the State’s Administrative Procedures act and 42 C.F.R. Subpart E – Fair Hearings for Applicants and Beneficiaries.
Sample 1
State Fair Hearings 
Sample 1Sample 2Sample 3See All (13)

Related to State Fair Hearings

  • Hearing Protection On vessels where there exists steady state and impact noise considered excessive, Officers shall be provided with adequate hearing protective devices. The noise exposure levels and standards of protective equipment shall be as provided for in the Transport Canada Coast Guard Standards Respecting Noise Control and Hearing Protection in Canadian Towboats over fifteen (15) Tons, Gross Tonnage, subject to the Marine Occupational Safety and Health Regulations.

  • Meetings and Hearings All meetings and hearings under this procedure shall not be conducted in public and shall include only such parties in interest and their designated or selected representatives, heretofore referred to in this Article.

  • Civil Actions Except where there has been gross negligence on the part of an employee, the Employer will:

  • Hearings The Hearing Officer shall hold hearings on a quarterly basis unless there are no appeals to hear or the parties agree to pend any open appeals. All materials considered in the position review shall be submitted to the Hearing Officer prior to the hearing and neither party will submit evidence at the hearing that was not submitted during the position review. The Hearing Officer shall endeavor to hold multiple hearings each day, and shall issue a concise decision which shall be final and binding. The Hearing Officer shall have no authority to alter the terms and conditions of this contract. Employees may be represented at the hearing and will be released from work with no loss of pay to attend the hearing. The Hearing Officer's fees and expenses shall be shared equally by the parties.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!