Section 20. Right To An Hsd Administrative Hearing

A. The human services department/medical assistance division (HSD/MAD) must grant an opportunity for an administrative hearing as described in this section in the following circumstances and pursuant to 42 CFR Section 431.220(a)(1), Section 27-3-3 NMSA 1978 and 8.352.2 NMAC Recipient Hearings: (1) when a supports waiver applicant has been determined not to meet the LOC requirement for waiver services; (2) when a supports waiver applicant has not been given the choice of HCBS as alternative to institutional care; (3) when a supports waiver applicant is denied the services of their choice or the provider of their choice; (4) when a supports waiver recipient’s services are denied, suspended, reduced or terminated; (5) when a supports waiver recipient has been involuntarily terminated from the program; or (6) when a supports waiver recipient’s request for a budget adjustment has been denied. B. DOH and its counsel, if necessary, shall participate in any fair hearing involving an eligible recipient. HSD/MAD, and its counsel, if necessary, may participate in fair hearings.