R410-14-5. Request for Hearing

  (1) An aggrieved person shall request a hearing by submitting the request on the DMHF "Request for Hearing/Agency Action" form. The aggrieved person must then mail or fax the form to the address or fax number contained on the Notice of Agency Action or Request for Hearing Form. The request must explain why the aggrieved person is seeking agency relief.

  (2) Except as set forth in Section R410-14-20, hearings must be requested within the following deadlines:

  (a) A medical assistance provider or recipient must request a hearing within 30 calendar days from the date that DMHF sends written notice of its intended action.

  (b) A medical assistance recipient must request a hearing with DWS regarding eligibility for medical assistance within 90 calendar days from the date that the agency sends written notice of its intended action.

  (c) A medical assistance recipient must request a hearing with DMHF regarding a determination of disability for the purposes of medical assistance eligibility within 90 calendar days from the date that DMHF sends written notice of its intended action.

  (d) A medical assistance recipient must request a hearing regarding approval or denial of a scope of service within 30 calendar days from the date the agency sends written notice of its intended action.

  (3) A hearing request that an aggrieved person sends via mail is deemed filed on the date of the postmark. If the postmark date is illegible, erroneous, or omitted, the request is deemed filed on the date that the agency receives it, unless the sender can demonstrate through competent evidence of the mailing date.

  (4) Failure to submit a timely request for a hearing constitutes a waiver of an individual's due process rights.

  (5) DMHF may dismiss a request for a hearing if the Aggrieved Person:

  (a) withdraws the request in writing;

  (b) verbally withdraws the hearing request at a prehearing conference;

  (c) fails to appear or participate in a scheduled proceeding without good cause;

  (d) prolongs the hearing process without good cause;

  (e) cannot be located or agency mail is returned without a forwarding address; or

  (f) does not respond to any correspondence from the hearing officer or fails to provide medical records that the agency requests.