SECTION 357.17. Types of Hearings

(a) Telephone and In-Person Hearings.

(1) The hearings officer conducts fair hearings by telephone ensuring that all parties are able to hear and respond to each other;

(2) An appellant may request that a hearing be conducted in person; and

(3) The hearings officer determines whether good cause for an in-person hearing exists.

(b) Expedited Appeals. The following hearings are expedited:

(1) Hearings for Transients--Transient appeals are SNAP and/or TANF appeals submitted by an appellant who plans to move from the jurisdiction of the hearings officer before the hearing decision would normally be issued. An example of a transient appeal is an appeal filed by a household that includes migrant farm workers. The hearing must be held and a decision made within 15 working days from the date the hearings officer receives the hearing request if:

(A) the appellant agrees to the reduced notice of the time, date, and place of the hearing; and

(B) the hearings officer has sufficient information available to make a decision without requesting additional information.

(2) Hearings for Individuals Whose Health Is Jeopardized--Any individual who believes and can demonstrate that a delay in his Medicaid hearing could seriously jeopardize his life or health may request an expedited fair hearing. Except as provided in subparagraph (A) of this paragraph, an individual receiving Medicaid services through a managed care organization (MCO) must exhaust the MCO's expedited appeals process before requesting an expedited fair hearing from the Health and Human Services Commission (HHSC). An individual does not need to exhaust the MCO's expedited appeals process before requesting a fair hearing that follows HHSC's standard fair hearing processes.

(A) An MCO must send an individual who has requested an expedited appeal a written notice of the outcome of the appeal, or a written notice denying the request. The individual may request an expedited fair hearing if the MCO has not sent a notice by the following deadlines:

(i) for requests relating to ongoing medical or dental emergencies or denials of continued hospitalization, no later than one business day after the MCO received the request; or

(ii) for all other requests, no later than three business days after the MCO received the request.

(B) During the expedited appeals process, an MCO must comply with the requirements of 42 C.F.R. §438.420, regarding the continuation of benefits.

(c) Group Hearings--The hearings officer may consolidate hearings, upon request of multiple appellants, if the sole issue involved in the cases is one of Federal or State law or policy. In all cases except SNAP cases, the request must be in writing, signed by each appellant, and state the common issue(s). Requests for group hearings in SNAP cases may be made orally or in writing. An appellant may also withdraw from a group hearing at any time before a final decision is issued. If an appellant wishes to withdraw, he must submit a signed request in writing. Group hearings follow the same procedures as individual hearings.

Source Note: The provisions of this §357.17 adopted to be effective June 29, 2009, 34 TexReg 4292; amended to be effective January 27, 2013, 38 TexReg 291