N.M. Admin. Code § 8.314.7.20

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.314.7.20 - RIGHT TO AN HSD ADMINISTRATIVE HEARING

A. The human services department/medical assistance division (HSD/MAD) must grant an opportunity for an administrative hearing as described in this section in the following circumstances and pursuant to 42 CFR Section 431.220(a)(1), Section 27-3-3 NMSA 1978 and 8.352.2 NMAC Recipient Hearings:

(1) when a supports waiver applicant has been determined not to meet the LOC requirement for waiver services;

(2) when a supports waiver applicant has not been given the choice of HCBS as alternative to institutional care;

(3) when a supports waiver applicant is denied the services of their choice or the provider of their choice;

(4) when a supports waiver recipient's services are denied, suspended, reduced or terminated;

(5) when a supports waiver recipient has been involuntarily terminated from the program; or

(6) when a supports waiver recipient's request for a budget adjustment has been denied.

B. DOH and its counsel, if necessary, shall participate in any fair hearing involving an eligible recipient. HSD/MAD, and its counsel, if necessary, may participate in fair hearings.

N.M. Admin. Code § 8.314.7.20

Adopted by New Mexico Register, Volume XXXII, Issue 06, March 23, 2021, eff. 4/1/2021