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. § 431.224

Expedited appeals

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(a) General rule. (1) The agency must establish and maintain an expedited fair hearing process for individuals to request an expedited fair hearing, if the agency determines that the time otherwise permitted for a hearing under § 431.244(f)(1) could jeopardize the individual's life, health or ability to attain, maintain, or regain maximum function.

(2) The agency must take final administrative action within the period of time permitted under § 431.244(f)(3) if the agency determines that the individual meets the criteria for an expedited fair hearing in paragraph (a)(1) of this section.

(b) Notice. The agency must notify the individual whether the request is granted or denied as expeditiously as possible. Such notice must be provided orally or through electronic means in accordance with § 435.918 of this chapter, if consistent with the individual's election under such section; if oral notice is provided, the agency must follow up with written notice, which may be through electronic means if consistent with the individual's election under § 435.918.

[81 FR 86449, Nov. 30, 2016]
Notes of Decisions
Cited in 2 cases (1 in the last 5 years), 2020–2024 · leading case: Lisnitzer v. Zucker, 983 F.3d 578 (2d Cir. 2020).
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Lisnitzer v. Zucker, 983 F.3d 578 (2d Cir. 2020). “” 42 C.F.R. § 431.224 (a)(1). Such expedited fair hearings require final 3 administrative action, § 431.”
Buckley v. Bassett (E.D.N.Y 2024). · cites it 2× “On March 3, 2022, Plaintiff requested an expedited fair hearing under 42 C.F.R. § 431.224 (a) to challenge what she considers HRA’s “constructive denial” of her Medicaid application.”
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