C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 431—STATE ORGANIZATION AND GENERAL ADMINISTRATION › Subpart E—Fair Hearings for Applicants and Beneficiaries

42 C.F.R. § 431.221

Request for hearing

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(a)(1) The agency must establish procedures that permit an individual, or an authorized representative as defined at § 435.923 of this chapter, to—

(i) Submit a hearing request via any of the modalities described in § 435.907(a) of this chapter, except that the requirement to establish procedures for submission of a fair hearing request described in § 435.907(a)(1), (2) and (5) of this chapter (relating to submissions via Internet Web site, telephone and other electronic means) is effective no later than the date described in § 435.1200(i) of this chapter; and

(ii) Include in a hearing request submitted under paragraph (a)(1)(i) of this section, a request for an expedited fair hearing.

(2) [Reserved]

(b) The agency may not limit or interfere with the applicant's or beneficiary's freedom to make a request for a hearing.

(c) The agency may assist the applicant or beneficiary in submitting and processing his request.

(d) The agency must allow the applicant or beneficiary a reasonable time, not to exceed 90 days from the date that notice of action is mailed, to request a hearings.

[44 FR 17932, Mar. 29, 1979, as amended at 81 FR 86448, Nov. 30, 2016]
Notes of Decisions
Cited in 16 cases (1 in the last 5 years), 1979–2021 · leading case: Philadelphia Welfare Rights Org. v. O'Bannon, 517 F. Supp. 501 (E.D. Pa. 1981).
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Philadelphia Welfare Rights Org. v. O'Bannon, 517 F. Supp. 501 (E.D. Pa. 1981). · cites it 3× “Indeed, the applicable federal regulation, 42 C.F.R. § 431.221 (d), 7 requires appeals to be filed within 90 days after notice of a proposed change is mailed to recipients.”
Washington v. DeBeaugrine, 658 F. Supp. 2d 1332 (N.D. Fla. 2009). “Indeed, 42 C.F.R. § 431.221 (b) broadly states that an agency “may not limit or interfere with the applicant’s or recipient’s freedom to make a request for a hearing.”
Rosen v. Tennessee Comm'r of Fin. & Admin., 280 F. Supp. 2d 743 (M.D. Tenn. 2002). · cites it 3× “” In such instances, coverage must be reinstated “if a recipient requests a hearing not more than 10 days after the date of the action.”
Stenson v. Blum, 476 F. Supp. 1331 (S.D.N.Y. 1979). “17,932 (1979) (to be codified at 42 C.F.R. § 431.221 (d)); in such a case, however, the state need not reinstate benefits pending decision at the hearing, id.”
JULIA M. v. Scott, 498 F. Supp. 2d 1245 (W.D. Mo. 2007). · cites it 2× “” 42 C.F.R. § 431.221 . Most importantly, and with immaterial exceptions, (a) If the agency mails the 10-day .”
Granato v. Bane, 74 F.3d 406 (2d Cir. 1996). “42 C.F.R. § 431.221 (d) (1994). If the recipient requests a hearing before the date of a proposed action, “the agency may not terminate or reduce services until a decision is rendered after the hearing,” except under narrowly prescribed circumstances.”
Flachs v. Illinois Dep't of Human Servs., 2021 IL App (4th) 200349-U (Ill. App. Ct. 2021). “See 42 C.F.R. § 431.221 (d) (2017) (“The agency must allow the applicant or beneficiary a reasonable time, not to exceed 90 days from the date that notice of action is mailed, to request a hearing.”
Schreur v. Dep't of Human Servs., 795 N.W.2d 192 (Mich. Ct. App. 2010). · cites it 10× “210 and 42 CFR 431.221, the statutory 90-day period had not begun to run.”
Randall ex rel. Liskey v. Lukhard, 709 F.2d 257 (4th Cir. 1983). “Under 42 C.F.R. § 431.221 , the state must allow a reasonable time for the applicant to request a hearing, but this is not to exceed ninety days from the date of decision.”
D.A. Vs. Div. of Med. Assistance & Health Servs. (Div. of Med. Assistance & Health Servs.) (N.J. Super. Ct. App. Div. 2020). · cites it 2× “The federal regulation that is controlling, 42 C.F.R. § 431.221 , authorizes states to place time limits on the submission of hearing requests.”
Ward v. Hunt, 667 F. Supp. 782 (M.D. Ala. 1987). “See 42 C.F.R. § 431.221 (d); Alabama Medicaid Agency Administrative Code, Chapter 3, Rule 560-X-3-.”
Amanda Schreur v. Dept of Human Servs. (Mich. 2011). · cites it 2× “210 and 42 CFR 431.221, the statutory 90-day period had not begun to run.”
Show all 16 citing cases →
— 42 C.F.R. § 431.221(a) — 1 case
Enriquez v. Miami Elevator Co., 50 Fla. Supp. 2d 148 (Fla. Cir. Ct. 1991).
— 42 C.F.R. § 431.221(d) — 3 cases
Schreur v. Dep't of Human Servs., 795 N.W.2d 192 (Mich. Ct. App. 2010). “210 and 42 CFR 431.221, the statutory 90-day period had not begun to run.”
Amanda Schreur v. Dept of Human Servs. (Mich. 2011). “210 and 42 CFR 431.221, the statutory 90-day period had not begun to run.”
Rosen v. Tennessee Comm'r of Fin. & Admin., 204 F. Supp. 2d 1061 (M.D. Tenn. 2001).
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