11114 RECONSIDERATION PROCESS

11114.1 If DDS denies any PDS or individual-directed goods or services requested in a participant's PDS budget, the participant may request reconsideration of the denial in accordance with § 11114.2.11114.2 If the participant wishes to request reconsideration of the denial, the following steps shall occur:- (a) The participant shall submit a written request for reconsideration to DDS within twenty-one (21) days of the postmark date on the notice of denial, containing the following elements:

- (1) The reason the participant believes the denial decision should not be upheld; and

- (2) Any additional information and/or documentation the participant believes is relevant to the reconsideration decision.

- (b) The Director of DDS or a designee shall issue a reconsideration decision within forty-five (45) days of the date the reconsideration request was received, containing the following elements:

- (1) An explanation of the reason the PDS budget denial was upheld or overturned; and

- (2) Information regarding the participant's right to appeal the reconsideration decision by filing a notice of appeal with the Office of Administrative Hearings.11114.3 A My Life, My Way program participant shall not be required to request reconsideration of the denial and may appeal the PDS budget denial decision directly by filing a notice of appeal with the Office of Administrative Hearings.

SOURCE: Final Rulemaking published at 70 DCR 008909 (June 23, 2023).