Authority: IC 12-13-2-3; IC 12-13-5-3

Affected: IC 12-15

Sec. 2. (a) For each applicant for or recipient of Medicaid who claims to have good cause, the DFR will determine, in accordance with sections 1, 3, and 4 of this rule, whether good cause exists.

(b) The DFR's final determination that good cause does or does not exist will:

1. (1) be in writing;
2. (2) contain the agency's findings and basis for determination; and
3. (3) be entered into the Medicaid case record.

(c) The DFR's determination of whether or not good cause exists will be made within forty-five (45) days from the day the good cause claim is made unless the department needs additional time because the information required to verify the claim cannot be obtained within the time standard, or that the claimant did not provide corroborative evidence within the period required by section 4(b) of this rule.

(d) If the DFR determines that good cause does not exist:

1. (1) the applicant or recipient will be notified and afforded an opportunity to cooperate, withdraw the application for assistance, or have the case closed; and
2. (2) continued refusal to cooperate will result in imposition of the sanction provided by 42 CFR 433.148.

(Division of Family Resources; 470 IAC 2.1-4-2; filed Jun 4, 1985, 2:37 p.m.: 8 IR 1299, eff Jul 1, 1985 [IC 4-22-2-5 suspends the effectiveness of a rule document for thirty (30) days after filing with the secretary of state. LSA Document #85-29 was filed Jun 4, 1985.]; readopted filed Jul 12, 2001, 1:40 p.m.: 24 IR 4235; readopted filed Oct 24, 2007, 11:25 a.m.: 20071121-IR-470070448RFA; readopted filed Aug 23, 2013, 3:36 p.m.: 20130918-IR-470130306RFA; readopted filed Nov 13, 2019, 11:56 a.m.: 20191211-IR- 470190490RFA; filed Aug 28, 2023, 9:55 a.m.: 20230927-IR-470230215FRA)