N.Y. Comp. Codes R. & Regs. tit. 9 § 9700.2

Current through Register Vol. 46, No. 50, December 11, 2024

Section 9700.2 - Applicants/participants

For applicants and participants, these regulations govern the following:

(a) Notice. These regulations set forth what information applicants and participants are entitled to receive with the notice of determination after reconsideration, if coverage has been refused or if there is to be a change in the coverage which the participant has been receiving.

(b) Timing. These regulations set forth the time periods within which applicants and participants are obligated to request a fair hearing after a written determination after reconsideration by the contractor.

(c) Procedures. These regulations set forth what applicants and participants are required to do to have a determination after reconsideration reviewed when you are refused coverage or there is a change in the coverage which you are receiving; how to request another hearing date if you are unable to go to the fair hearing on the day it is to be held; how to get an interpreter if you do not speak English or if you are deaf; and who may come with you to a fair hearing.

(d) Decision. These regulations set forth what you should do if the contractor refuses to comply with the fair hearing decision.

N.Y. Comp. Codes R. & Regs. Tit. 9 § 9700.2