SECTION .0200 - RECONSIDERATION REVIEW

 

10A NCAC 21D .0201       RECONSIDERATION REVIEW

(a)  The recipient or his parent/guardian/responsible person acting on behalf of the recipient may request reconsideration of the determination that the individual cannot reasonably be expected to be discharged to return home based on relevant evidence stated in Rule .0101 of this Subchapter.

(b)  A reconsideration review shall be requested in writing to the Division of Medical Assistance estate recovery administrator within 30 calendar days of the determination and written notice provided by the county department of social services.

(c)  Within 30 calendar days of a written request for reconsideration of the determination of permanent institutionalization, the estate recovery administrator shall establish a reconsideration date and conduct a review of:

(1)           All evidence considered by the county department of social services in making a determination of permanent institutionalization, and

(2)           Information provided in writing or by telephone conference with the recipient or an individual acting on behalf of the recipient.

(d)  The review shall be conducted in the Division of Medical Assistance offices and may include a telephone conference with the recipient or an individual acting on behalf of the recipient if oral testimony is requested.

(e)  A decision shall be made and provided in writing to the recipient or an individual acting on behalf of the recipient within 15 calendar days of the date of the reconsideration review.

(f)  If the recipient disagrees with the decision of the reconsideration review, he may appeal to the Office of Administrative Hearings (OAH) within 60 calendar days of receipt of the reconsideration review decision.  If no appeal to OAH is filed, the reconsideration review decision is final.

 

History Note:        Authority G.S. 108A-70.5; 42 U.S.C. 1396p.;

Temporary Adoption Eff. May 6, 1996 to expire on July 1, 1996, or the last day of the 1996 session of the General Assembly, whichever is later;

Temporary Rule Expired on July 1, 1996;

Eff. July 1, 1996.