SECTION 331.23. Review Process

(a) Medicaid-eligible individuals. Any Medicaid-eligible individual whose request for eligibility for service coordination is denied or is not acted upon with reasonable promptness, or whose service coordination has been terminated, suspended, or reduced by the department is entitled to a fair hearing in accordance with 1 TAC Chapter 357, Subchapter A (relating to Uniform Fair Hearing Rules).

(b) Non-Medicaid-eligible individuals. If an MRA decides to deny, involuntarily reduce, or terminate service coordination for a non-Medicaid-eligible individual, the MRA must notify the individual or LAR in writing of the decision and provide an explanation of the procedure for the individual or LAR to request a review by the MRA as required by §2.46 of this chapter (relating to Notification and Appeals Process).

Source Note: The provisions of this §331.23 adopted to be effective August 31, 2004, 29 TexReg 8313; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective August 1, 2005, 30 TexReg 4334; amended to be effective June 1, 2010, 35 TexReg 4439; transferred effective July 1, 2022, as published in the Texas Register June 3, 2022, 47 TexReg 3275