1. (a) The department shall continue to monitor cost effectiveness monthly and determine it annually in accordance with He-W 508.06, for recipients who submit and implement a cost reduction plan in accordance with He-W 508.07(f)(5).

2. (b) The department shall terminate a recipient’s medical eligibility for HC-CSD if:

   1. (1) The recipient submits a cost reduction plan that does not demonstrate cost effectiveness in accordance with He-W 508.07(f)(2);
   2. (2) The recipient submits a cost reduction plan that demonstrates cost effectiveness, but does not implement the cost effectiveness plan in accordance with He-W 508.07(f)(5); or
   3. (3) The recipient does not submit a cost reduction plan in accordance with He-W 508.07(f)(5).
3. (c) A recipient’s termination of medical eligibility for HC-CSD, in accordance with (b) above, shall be effective 30 days after the due date of the written plan in He-W 508.07(f)(5).

4. (d) The recipient shall receive a written notice of termination of medical eligibility on department Form 272hc, “Termination of Medical Eligibility for HC-CSD,” including:

   1. (1) The reason for, and legal basis of, the termination;
   2. (2) Information that a fair hearing on the termination may be requested within 30 calendar days of the date on the notice of termination, in accordance with He-C 200.
5. (e) The department shall continue the recipient’s medical eligibility after the termination date of medical eligibility in accordance with (b) above when the recipient submits to the local district office both a request for a fair hearing and for a continuation of benefits during the appeal process not later than 10 calendar days from the date on the written notice of termination.

Source. #9291, eff 7-1-09