Section 17a-451(t)-9 - Further review(a) A client may request the Commissioner or the Commissioner's designee to conduct a further review of a decision of a covered service provider not later than fifteen business days after the client's receipt of the covered service provider's decision, unless the time is extended by the Commissioner or the Commissioner's designee for good cause shown. If a decision of a covered service provider is not more than seven business days overdue, the client may treat it as a denial and request further review. Additionally, if the covered service provider fails to implement an informal resolution that was agreed to by the client, and where such failure is not due to the client's action or inaction, the client may request further review. A request for further review shall be in writing, and shall state what decision of the covered service provider is being reviewed and the grounds upon which the request is based.(b) Upon receipt of the request for further review, the Commissioner's designee shall conduct such additional investigation as the Commissioner's designee determines is necessary, receive additional information from the parties, and may convene a conference of all parties to be held not later than twenty-one calendar days after the receipt of the request for further review. If the grievance cannot be informally resolved the Commissioner's designee shall issue a written decision not later than fifteen calendar days after the date of the conference, or not later than twenty-one calendar days after receipt of the request for further review, if no conference is held. The written decision of the Commissioner's designee shall serve as DMHAS' final determination.(c) If the final determination results in the denial, involuntary reduction or termination of mental health or substance use disorder services, it shall include a statement informing the client that the client may request a hearing as specified in section 17a-451(t) -10 to 17a-451 (t)-19, inclusive, of the Regulations of Connecticut State Agencies.Conn. Agencies Regs. § 17a-451(t)-9
Effective August 3, 1998; Amended June 29, 2012