1. (1) If the agency mails a notice of agency action in the time required by Section R410-14-3 and the recipient requests a hearing within ten days of the date the notice was mailed, the agency shall continue services until a decision is rendered after the hearing. The agency may terminate or reduce services if it is determined at the hearing that the sole issue is one of federal or state law or policy and the agency promptly informs the recipient in writing that services are to be terminated or reduced pending the hearing decision.

2. (2)(a) The agency may reinstate services if a recipient requests a hearing no more than ten days after the date of the action. The reinstated services shall continue until a hearing decision is rendered unless, at the hearing, it is determined that the sole issue is one of federal or state law or policy.

   1. (b) The agency shall reinstate and continue services until a decision is rendered after a hearing if:

      1. (i) the agency takes action without giving a ten-day notice as required by Section R410-14-3;
      2. (ii) the recipient requests a hearing no more than ten days after the date the notice of agency action is mailed; and
      3. (iii) the action is not the result of the application of federal or state law or policy.

KEY: Medicaid

Date of Last Change: September 19, 2025

Notice of Continuation: August 12, 2022

Authorizing, and Implemented or Interpreted Law: 26B-1-202(1); 26B-1-204; 63G-4-102