Grounds for Appeal

Applicants and participants have a right to request a fair hearing in any of the situations described below: (a) Denial of an application or request for participation in MRRP or a component under MRRP or the right to apply or reapply for participation in MRRP or a component under MRRP; (b) The failure of a Case Management Provider to give notice in a timely manner of action on an application for MRRP; (c) A Case Management Provider action concerning the suspension, reduction or termination of assistance of any kind under MRRP; (d) The failure of the Case Management Provider to give notice in a timely manner of action taken on a request for increased assistance; (e) Unresolved disputes involving: 1. issues concerning employment or training services, including, but not limited, to the designation of a participant, exemption from participation status, good cause determination; 2. scope and amount of payment; or 3. a decision to recoup an overpayment; (f) Any condition of eligibility for, or receipt of, assistance which is not authorized by 121 CMR 2.400 through 2.565; (g) The failure of the Case Management Provider to act upon a request for assistance within time limits required by 121 CMR 2.600: Determination of Initial and Continuing Eligibility. (h) A denial or termination of eligibility for Refugee Medical Assistance. If a specific medical service is denied or a provider of medical services is denied, the appeal is through the Division of MassHealth.