10.18.07.06

.06 Reconsideration and Appeal.

A. An applicant or recipient who has been notified by the Department of disenrollment or ineligibility for MADAP-Plus benefits may request reconsideration of the decision by submitting additional supporting documentation or information to the Department within 30 business days of notification.

B. If an applicant or recipient submits a timely request for reconsideration, the Department shall:

(1) Review all additional supporting documentation, within five business days of the Departmentís receipt of the request for reconsideration; and

(2) Issue a final decision in writing to the applicant or recipient.

C. If an applicant or recipient is dissatisfied with the final decision of the Department, the applicant or recipient may appeal the reconsideration by requesting in writing for a hearing with the Department.

D. The Office of Administrative Hearings shall:

(1) Conduct a hearing according to the procedures set forth in COMAR 28.02.01;

(2) Hold a hearing to review the decision within 45 days of the postmarked date on the letter requesting a hearing; and

(3) Issue a decision in writing to the applicant or recipient.

E. The Department shall pay any health insurance plan or prescription drug plan costs due pending a decision by the Office of Administrative Hearings.

F. If the final decision finds in favor of the Department, the Department shall, upon the date of the decision, cease paying the health insurance costs allowed under this chapter and seek recovery in accordance with Regulation .08 of this chapter.