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SCE Fair Hearing and Appeal Requirements

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On February 11, 2019, the Office of Long-Term Living (OLTL) released Bulletin 59-19-03, Hearings and Appeals. The bulletin provides the responsibilities of Service Coordination Entities (SCEs) with respect to the notice and fair hearing requirements. Also included with the bulletin are the following attachments:

  1. MA 561 – Notice of Service Determination and the Right to Appeal
  2. MA 562 – Decision to Withdraw an Appeal Request
  3. MS 561 – MA 561 Form Instructions for Service Coordinators
  4. Bureau of Hearings and Appeals Agency Appeal Cover Sheet
  5. Bureau of Hearings and Appeals Agency Appeal Cover Sheet Instructions
  6. OHA 147 – Bureau of Hearings and Appeals Agency Expedited Information Sheet
  7. BHA Regions Chart

The bulletin is updated to reflect expedited appeals requirements that were established by the Medicaid Eligibility Final Rule and can be found in 42 CFR Part 431.224. The SCEs are responsible to understand the rights and procedures set forth in the state regulations and federal regulations. The bulletin highlights the many requirements of the SCEs.

OLTL has scheduled a webinar for Monday, February 25, 2019 at 2:00 pm to answer questions SCEs may have in relation to this bulletin. Please register here. After registering, you will receive a confirmation email containing information about joining the webinar. Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with questions.