WAG 01-07-11-b: Action Not Upheld

PM 01-07-11-b

NOTE: See WAG 26-04-03 for payments of Supplemental Child Care by the Special Projects Unit.

For all cash, medical, and FS cases:

(LO/Other) Complete Implementation of Appeal Decision (Form 1456). Form 1456 must show all steps taken and the dates actions were taken. If HFS or its agent is responsible for the action, they complete the form.

(LO/Other) Send original Form 1456 to the Bureau of Assistance Hearings with a copy of the new decision summary.

(LO/Other) For dental or other medical services where the decision is not upheld, Bureau of Comprehensive Health Services (BCHS) completes Form 1456.

(LO/Other) For payment of health insurance premiums through the HIPP Program where the decision is not upheld, the HIPP Unit completes Form 1456.

(LO/Other) If the decision indicates that medical assistance must be authorized for a period previously not covered, submit Request for Correction/Addition to MMIS Medical Eligibility File (Form 2958) to the Exception Processing Unit, Springfield (see PM 15-07-00 ).

(LO/Other) For child care, BCCD completes Form 1456.

(LO/Other) File a copy of Form 1456 and the decision summary in the case record.