Fair Hearings definition

Fair Hearings means the appeals process federally mandated for the title IV-E independent living program by 45

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Fair Hearings means the appeals process federally mandated for the title IV-E independent living program by 45 C.F.R. 1356.10 and 45 C.F.R. 1355.30. The required details of this appeals process are provided in 45 C.F.R. 205.10. The Department of Children and Families has already incorporated this appeals process, in Chapter 65-2, F.A.C., for other federal public assistance programs. However, certain provisions for Independent Living Fair Hearings which differ from those for other programs will be listed in the [next] draft of Rule 65C-28.0200, F.A.C.

Fair Hearings means the appeals process federally mandated for the title IV-E independent living program by 45 C.F.R. 1356.10 and 45 C.F.R. 1355.30. The required details of this appeals process are provided in 45

Examples of Fair Hearings in a sentence

• By execution of this Agreement, the Facility, its agents, representatives, successors and assigns shall be authorized to have access to the Resident’s Medicaid file, and, if the Facility so elects, to act on behalf of the Resident in connection with any and all matters involving Medicaid, including, but not limited to, representation of the Resident at Administrative Fair Hearings and Article 78 judicial appeals.

• The evidence packet must comply with HHSC’s Fair Hearings requirements.

• If a Member requests a Fair Hearing, the MCO will complete the request for Fair Hearing and submit the form via facsimile to the appropriate Fair Hearings office, within five (5) calendar days of the Member's request for a Fair Hearing.

• Within five (5) calendar days of notification that the Fair Hearing is set, the MCO will prepare an evidence packet for submission to the HHSC Fair Hearings staff and send a copy of the packet to the Member.

• Within five (5) calendar days of notification that the Fair Hearing is set, the HMO will prepare an evidence packet for submission to the HHSC Fair Hearings staff and send a copy of the packet to the Member.

• If a Member requests a Fair Hearing, the HMO will complete the request for Fair Hearing, and submit the form via facsimile to the appropriate Fair Hearings office, within five (5) calendar days of the Member's request for a Fair Hearing.

• Chapter 4201 is pre-empted by federal Fair Hearings requirements.

• PROVIDER agrees to comply with applicable sections of Federal law 42CFR 431.200-250 and 42CFR 438.400-438.424 regarding Grievance, Appeals, and Fair Hearings.

• HMO is required to comply with the requirements contained in 1 TAC Chapter 357, relating to notice and Fair Hearings in the Medicaid program, whenever an action is taken to deny, delay, reduce, terminate or suspend a covered service.

• The Participant's right to request a Fair Hearing, the methods for obtaining a Fair Hearing, the time frame for requesting a Fair Hearing after a Complaint or Grievance has been decided, the rules that govern representation at Fair Hearings, the ability to continue to receive requested services if the Participant files a request for a Fair Hearing within ten (10) days from the mail date on the written notice of a Complaint or Grievance decision to terminate or reduce currently Authorized Services.

More Definitions of Fair Hearings

Fair Hearings means the appeals process federally mandated for the title IV-E Iindependent Lliving Pprogram by 45 C.F.R. 1356.10 and 45 C.F.R. 1355.30. The required details of this appeals process are provided in 45 C.F.R. 205.10 incorporated by reference. A copy of the federal regulation is available upon request by contacting the Office of Family Safety, 1317 Winewood Blvd., Tallahassee, Florida 32399. The Department of Children and Family Services has already incorporated this appeals process, in Chapter 65-2, F.A.C., for other federal public assistance programs. However, certain provisions for Independent Living Fair Hearings which differ from those for other programs can be found in Rule 65C-31.009, F.A.C. will be listed in the [next] draft of Rule 65C-28.0200, F.A.C.

Fair Hearings. BEFORE THE ADMINISTRATION. 3.8.7.1 The TPA/HCO shall explain to enrollees their rights and the procedures concerning “fair hearings” before the ADMINISTRATION. The parties at a hearing must include the TPA/HCO, as well as the enrollee, its representative, or an estate representative of a deceased enrollee. The enrollee or provider may file an appeal within a reasonable timeframe that cannot be less than 20 days, and may not exceed 90 days from the date of the notice of TPA/HCO’s disposition of the appeal concerning a complaint/grievance or other action. 3.8.7.2 The ADMINISTRATION’s hearing decision shall be within the following timeframe: a) Ninety (90)

Fair Hearings before the ADMINISTRATION shall be conducted subject to the applicable provisions of the Uniform Administrative Procedure Act, Law No. 170 of August 12, 1988, as amended, including that decisions issued by the ADMINISTRATION through “fair hearings” are subject to review before the San ▇▇▇▇ Panel of the Court of Appeals of the Commonwealth of Puerto Rico.

Fair Hearings means the process adopted and implemented by the Texas Department of Health, 25 TAC Chapter 1, in compliance with federal regulations and state rules relating to Medicaid Fair Hearings Part 431, found at 42 CFR Subpart E, and 1 TAC, Chapter 357. Health care services means medically necessary physical medicine, behavioral health care and health-related services which an enrolled population might reasonably require in order to be maintained in health, including, as a minimum, emergency services and inpatient and outpatient services. Linguistic access means translation and interpreter services, for written and spoken language to ensure effective communication. Linguistic access includes sign language interpretation and the provision of other auxiliary aids and services to persons with disabilities. Medically necessary health care services means health care services, other than behavioral health care services which are: