Authority to File. i. A beneficiary may file a grievance and request an appeal with the Contractor. A beneficiary may request a state fair hearing after receiving notice under 42 CFR §438.408 that the adverse benefit determination is upheld. 1. In the case that the Contractor fails to adhere to the notice and timing requirements in 42 CFR §438.408, the beneficiary is deemed to have exhausted the Contractor’s appeals process. The beneficiary may initiate a state fair hearing.
Appears in 20 contracts
Sources: Intergovernmental Agreement, Intergovernmental Agreement, Intergovernmental Agreement
Authority to File. i. A beneficiary may file a grievance and request an appeal with the Contractor. A beneficiary may request a state fair hearing after receiving notice under 42 CFR §438.408 that the adverse benefit determination is upheld.
1. In the case that the Contractor fails to adhere to the notice and timing requirements in 42 CFR §438.408, the beneficiary is deemed to have exhausted the Contractor’s appeals process. The beneficiary may initiate a state fair hearing.
Appears in 6 contracts
Sources: Behavioral Health Services Agreement, Standard Agreement Amendment, Standard Agreement
Authority to File. i. A beneficiary may file a grievance and request an appeal with the Contractor. A beneficiary may request a state fair hearing after receiving notice under 42 CFR §438.408 that the adverse benefit determination is upheld.
1. In the case that the Contractor fails to adhere to the notice and timing requirements in 42 CFR §438.408, the beneficiary is deemed to have exhausted the Contractor’s appeals process. The beneficiary may initiate a state fair hearing.
Appears in 4 contracts
Sources: Intergovernmental Agreement, Amendment to STD 213, Intergovernmental Agreement
Authority to File. i. A beneficiary may file a grievance and request an appeal with the Contractor. A beneficiary may request a state fair hearing after receiving notice under 42 CFR §438.408 that the adverse benefit determination is upheld.
1. In the case that the Contractor fails to adhere to the notice and timing requirements in 42 CFR §438.408, the beneficiary is deemed to have exhausted the Contractor’s appeals process. The beneficiary may initiate a state fair hearing.
Appears in 1 contract
Sources: Intergovernmental Agreement
Authority to File. i. A beneficiary may file a grievance and request an appeal with the Contractor. A beneficiary may request a state fair hearing after receiving notice under 42 CFR §438.408 that the adverse benefit determination is upheld.
1. In the case that the Contractor fails to adhere to the notice and timing requirements in 42 CFR §438.408, the beneficiary is deemed to have exhausted the Contractor’s appeals process. The beneficiary may initiate a state fair hearing.
Appears in 1 contract
Sources: Agreement