42 C.F.R. § 431.232
Adverse decision of local evidentiary hearing
If the decision of a local evidentiary hearing is adverse to the applicant or beneficiary, the agency must—
(a) Inform the applicant or beneficiary of the decision;
(b) Inform the applicant or beneficiary in writing that he or she has a right to appeal the decision to the State agency within 10 days after the individual receives the notice of the adverse decision. The date on which the notice is received is considered to be 5 days after the date on the notice, unless the individual shows that he or she did not receive the notice within the 5-day period; and
(c) Inform the applicant or beneficiary of his right to request that his appeal be a de novo hearing; and
(d) Discontinue services after the adverse decision.
Notes of Decisions
Cited in 6
cases, 1996–2010 · leading case: Doe v. Kidd, 501 F.3d 348 (4th Cir. 2007).
Doe v. Kidd, 501 F.3d 348 (4th Cir. 2007). “" 42 C.F.R. § 431.232 (d) (emphasis added).”
Albert S. v. Dep't of Health & Mental Hygiene, 891 A.2d 402 (Md. Ct. Spec. App. 2006). “Presumably, this concession implies that the fair hearing procedures under 42 CFR 431.232 and COMAR 10.01.04.01 et seq.”
Murphy v. Curtis, 930 N.E.2d 1228 (Ind. Ct. App. 2010). “232 provides if the decision of a local evidentiary hearing is adverse to the applicant or recipient, the agency must "[i]nform the applicant or recipient of his right to request that his appeal be a de novo hearing." (Emphasis supplied). Under § 431.240, If the hearing involves…”
Curtis v. Roob, 891 N.E.2d 577 (Ind. Ct. App. 2008). “” (Emphasis supplied.) Under § 431.240, If the hearing involves medical issues such as those concerning a diagnosis, an examining physician’s report, or a medical review team’s decision, and if the hearing officer considers it necessary to have a medical assessment other than…”
Perry v. Chen, 985 F. Supp. 1197 (D. Ariz. 1996). “” 42 C.F.R. § 431.232 (emphasis added). Finally, the hearing must cover “[a]gency decisions regarding the type or amount of services.”
Rosen v. Tennessee Comm'r of Fin. & Admin., 204 F. Supp. 2d 1061 (M.D. Tenn. 2001). “42 C.F.R. § 431.232 (b). These time references are to observe that there is ample basis to expedite the verification process to remove all unqualified persons from TennCare enrollment.”
— 42 C.F.R. § 431.232(c) — 1 case
Albert S. v. Dep't of Health & Mental Hygiene, 891 A.2d 402 (Md. Ct. Spec. App. 2006). “Presumably, this concession implies that the fair hearing procedures under 42 CFR 431.232 and COMAR 10.01.04.01 et seq.”
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