23 Miss. Code. R. 101-9.3

Current through December 10, 2024

Rule 23-101-9.3 - Adverse Action

A. Advance notice of an adverse action is generally required, if the eligibility decision results in:

1. Termination of benefits;

2. Conversion to a reduced services coverage group;

3. Increase in the amount of patient liability; and

4. Termination of a nursing facility vendor payment.

B. During the advance notice period, the recipient is allowed at least ten days notice before the date of the action. During this time, the recipient can fully comply with unmet redetermination requirements, provide information or verification that will alter the decision to terminate or reduce benefits, or request a Fair Hearing with continued benefits.

23 Miss. Code. R. 101-9.3

42 CFR §431.211 (Rev. 1986).