PM 01-07-06: Pre-Hearing Review

WAG 01-07-06

Within 7 days after the appeal is filed, the worker and supervisor must meet and review the action under appeal to decide if:

the client was sent a proper notice;

correct policy and procedures were used; and

all figures were correct and for the right periods.

If a mistake was made, stop or change the action as needed. Notify the client in writing that either:

We are dropping the action and leaving the benefits at the level they were before. Ask the client to withdraw the appeal; or

We have decided to change the action after our review, and we are taking another action.

NOTE: The client may choose not to withdraw the appeal and may also file an appeal on the new action.

If the review finds that the original action was correct, make sure that all paperwork and verifications are available for the appeal.

An appeal may be about an action taken by DHS staff who are not in the Family Community Resource Center. Contact the office responsible for the action for any directions or paperwork needed to support the action. The Family Community Resource Center Appeals Coordinator is responsible for obtaining the information from that office.

For an appeal regarding a DentaQuest decision or other HFS decision, notify the HFS Fair Hearings Section (FHS). The FHS phone number is 1-800-435-0774. FHS contacts DentaQuest or other responsible party for follow-up. The Family Community Resource Center does not conduct a pre-hearing review or pre-hearing meeting for these appeals.

For example, the HFS central office Recipient Restriction Unit schedules and conducts the pre-hearing review and meeting for appeals of decisions restricting a client to a Primary Care Provider (PCP). The Bureau of Collections (BOC) conducts the pre-hearing review on an appeal of action to file a lien on real property owned by a long-term care client.

For child care appeals, the Bureau of Child Care and Development obtains all information and evidence about the appeal from the CCR&R and/or provider and reviews it for accuracy.

When the appeal includes a determination of whether or not a signature is genuine, the FCRC Appeal Coordinator sends copies of the appeal request and evidence to the Bureau of Operations Support (BOS). BOS forwards the information to the Department's Forensic Document Examiner (FDE) and contacts BAH so they can coordinate scheduling of the hearing with the FDE. Prior to the hearing, the Family Community Resource Center receives copies of the FDE's statement of qualifications, signatures used in the determination, and conclusions in the case, to present at the hearing. The FDE keeps the originals and testifies from them by telephone during the hearing.