Notice

(A) The MassHealth agency provides all applicants and members a written notice of the eligibility determination for MassHealth. The notice contains an eligibility decision for each member who has requested MassHealth, and either provides information so the applicant or member can determine the reason for any adverse decision or directs the applicant or member to such information. (B) The MassHealth agency also provides to members notice of any changes in coverage type or patient-paid amount, or loss of coverage. (C) In addition to sending notices to applicants and members, such written notices are provided to the authorized representative; the institution, if authorized by the applicant or member; and the community spouse, as defined at 130 CMR 520.016(B)(1)(c): Right to Appeal. This may include, in the case of death, the executor, administrator, or legal representative of the deceased individual's estate. (D) All notices provide information about the right of the applicant or member to a fair hearing, with the exception of asset assessments described at 130 CMR 520.016: Long-term Care: Treatment of Assets and notices about federal or state law requiring an automatic change adversely affecting some or all members as described in 42 CFR 431.220(b). Information about the appeal process is found at 130 CMR 610.000: MassHealth: Fair Hearing Rules.