N.D. Admin. Code 75-02-13-04

Current through Supplement No. 395, January, 2025

Section 75-02-13-04 - Denials - Revocations - Terminations - Appeals

1. The department shall issue a written notice to an applicant, eligible participant, or a legally responsible individual if the department denies, revokes, or terminates.

2. The department shall include the reason for the denial, revocation, or termination and shall inform the applicant, eligible participant, or legally responsible individual of the right to appeal the denial, revocation, or termination, if applicable.

3. An application may be denied, revoked, or terminated under the terms and conditions of this chapter or North Dakota Century Code section 50-24.1-47.

4. An applicant, eligible participant, or legally responsible individual may appeal a denial, revocation, or termination of an application or authorization under this chapter. An appeal under this section must be made in writing within thirty days of the date of the notice issued under this section. The applicant, eligible participant, or legally responsible individual shall submit the written request for an appeal and hearing under chapter 75-01-03 and North Dakota Century Code chapter 28-32 to the appeals supervisor for the department.

5. An applicant, eligible participant, or legally responsible individual may not appeal:

a. A denial, revocation, termination, or reduction in payment resulting from exhausting or exceeding the limits of legislative appropriations for the family paid caregiver program;

b. A denial, revocation, or termination of an application or authorization under this chapter if the applicant is no longer eligible for a Medicaid 1915(c) waiver at the time of the denial, revocation, or termination; or

c. An application that has been withdrawn.

6. A family caregiver is not entitled to payment upon notice of revocation or termination to the eligible participant or legally responsible individual or during an appeal.

N.D. Admin Code 75-02-13-04

Adopted by Administrative Rules Supplement 2024-392, April 2024, effective 4/1/2024.

General Authority: NDCC 50-24.1-47

Law Implemented: NDCC 50-24.1-47