42 C.F.R. § 431.241
Matters to be considered at the hearing
The hearing must cover—
(a) Any matter described in § 431.220(a)(1) for which an individual requests a fair hearing.
(b) A decision by a skilled nursing facility or nursing facility to transfer or discharge a resident; and
(c) A State determination with regard to the preadmission screening and annual resident review requirements of section 1919(e)(7) of the Act.
Notes of Decisions
Cited in 8
cases, 1980–2019 · leading case: Melissa Wilson v. Darin Gordon, 822 F.3d 934 (6th Cir. 2016).
Melissa Wilson v. Darin Gordon, 822 F.3d 934 (6th Cir. 2016). “” 42 C.F.R. § 431.241 (a). Moreover, a state is required to designate a “single State agency to administer or to supervise the administration of the plan.”
Murphy v. Curtis, 930 N.E.2d 1228 (Ind. Ct. App. 2010). “241 (a) provides that the review hearing "must cover(a) Agency action or failure to act with reasonable promptness on a claim for services, including both initial and subsequent decisions regarding eligibility." (emphasis added). The "agency action" under review in the present…”
Prunckun v. Delaware Dept. of Health & Soc. Servs. Oldham v. Delaware Dept. of Health & Soc. Servs., 201 A.3d 525 (Del. 2019). “Appellants also rely on 42 C.F.R. § 431.241 (2017) ("Matters to be considered at the hearing").”
Ladd v. Thomas, 962 F. Supp. 284 (D. Conn. 1997). “§ 1396a(a)(3); see also 42 C.F.R. § 431.241 . There is no prescribed time limit in which DSS must act on a recipient’s request for services, and the uncontradicted evidence submitted shows that Medicaid recipients are at the mercy of the DME vendor to inform them that their…”
Kessler v. Blum, 591 F. Supp. 1013 (S.D.N.Y. 1984). “Plaintiffs also claim that unless recipients are allowed to submit requests they have no way of knowing how long the agency is taking to make the determination, and are thus “effectively deprived of their right to a hearing to contest delays” under 42 C.F.R. § 431.241 . This…”
Perry v. Chen, 985 F. Supp. 1197 (D. Ariz. 1996). “” 42 C.F.R. § 431.241 (emphasis added). Clearly these federal notice regulations envision written notice and hearing if requested when the amount or type of services are reduced.”
Granato v. Bane, 74 F.3d 406 (2d Cir. 1996). “” 42 C.F.R. § 431.241 (b) (1994). If a recipient wishes to contest an adverse action taken by the agency, he or she must request a hearing within ninety days of the date the notice is mailed.”
Featherston v. Stanton, 626 F.2d 591 (7th Cir. 1980). “Consequently, we hold that claimants’ procedural rights under 42 C.F.R. §§ 431.241 & 431.242 are violated when a medical or dental review team does not give a reasoned basis for its denial of benefits.”
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