Technical Issues Filing Medicaid Appeals

Interim Study Committee on Communication Between the Department of Health Care Policy and Financing (HCPF) and Medicaid Clients.

The bill clarifies that a medicaid recipient (recipient) who files an appeal does not need to make an affirmative request to continue medicaid benefits during the appeal. The bill requires the department of health care policy and financing (department) to send the recipient written confirmation of continuing benefits. For a recipient who chooses not to continue receiving benefits during the appeal process, the form and electronic filing process for appeals must include a check box or other method to opt out of continuing benefits.

The bill requires the form and electronic filing process for appeals to include a check box or other method to request an accommodation to file the appeal or to participate in the hearing and to request the county or service delivery agency dispute resolution process.

Additionally, the electronic appeals filing website must allow the applicant or recipient to attach the number of documents sufficient to support the appeal along with the appeal form.

(Note: This summary applies to this bill as introduced.)