(a) The agency must:
- (1) follow the notice requirements set forth in the appropriate state or federal law or regulation for the affected program;
- (2) give clients timely and adequate notice, as appropriate, of the right to a fair hearing;
- (3) explain the right of appeal;
- (4) explain the procedures for requesting an appeal;
- (5) explain the right to be represented by others, including legal counsel;
- (6) provide information about legal services available in the community;
- (7) continue benefits if required to do so by state or federal law or regulations of the affected program; and
- (8) not reinstate or continue SNAP benefits if a client requests a fair hearing after the date his certification period has ended.
(b) In Medicaid cases, except as specifically provided in federal regulations, the following apply:
(1) The written notice to an individual of the individual's right to a hearing must:
- (A) contain an explanation of the circumstances under which Medicaid is continued if a hearing is requested; and
- (B) be mailed at least 10 days before the date the individual's Medicaid eligibility or service is scheduled to be terminated, suspended, or reduced, except as provided by federal rules.
(2) If a hearing is requested before the date a Medicaid recipient's service, including a service that requires prior authorization, is scheduled to be terminated, suspended, or reduced, the agency may not take that proposed action before a decision is rendered after the hearing unless:
- (A) it is determined at the hearing that the sole issue is one of federal or state law or policy; and
- (B) the agency promptly informs the recipient in writing that services are to be terminated, suspended, or reduced pending the hearing decision.
Source Note:The provisions of this §357.11 adopted to be effective June 29, 2009, 34 TexReg 4292.