Font Size
-
+

Eligibility Policy and Procedures Manual

Eligibility Policy and Procedures Manual

Chapter 100: General Provisions

Chapter 100 – General Provisions
Section 100.01 – History and Legal Base
Section 100.02 – Agency Duties

Section 100.02.01 – Duties of the Division of Medicaid (DOM)
Section 100.02.02 – Duties of the Department of Human Services (DHS)

Section 100.03 – Rights of Applicants and Recipients

Section 100.03.01 – Opportunity to Apply
Section 100.03.02 – Civil Rights and Non-Discrimination
Section 100.03.03 – Access to Information
Section 100.03.04 – Confidentiality of Information

Section 100.03.04A – Release of Information Without Client Consent
Section 100.03.04B – Release of Program Information
Section 100.03.04C – Safeguarding Confidential Information
Section 100.03.04D – Safeguard Awareness Training

Section 100.03.05 – Right to Appeal Fair Hearing

Section 100.03.05B – Continuation of Benefits
Section 100.03.05C – Regional Office Responsibilities in the Hearing Process

Section 100.03.05C1 – Supervisory Review
Section 100.03.05C2 – Preparation of the Hearing Record
Section 100.03.05C3 – Holding the Local Hearing
Section 100.03.05C4 – Issuing the Local Hearing Decision
Section 100.03.05C5 – Taking Action on the Case
Section 100.03.05C6 – State Hearing Requested After Adverse Local Decision

Section 100.03.06 – State Hearings

Section 100.03.06A – Review by State Hearing Officer
Section 100.03.06B – Holding the State Hearing
Section 100.03.06C – Recessing or Continuing a State Hearing
Section 100.03.06D – Changes Which Occur During the Hearing Process
Section 100.03.06E – Review by DDS Staff
Section 100.03.06F – Recommendation of the State Hearing Officer
Section 100.03.06G – Decision of the Agency
Section 100.03.06H – Chip Agency Errors

Section 100.04 – Improper Payments

Section 100.04.01 – Improper Payment Report
Section 100.04.02 – Claims Against Estates

Section 100.05 – Quality Control

Section 100.05.01 – MEQC Disagreement Resolution Process