(1) Waiver applicants will be afforded fair hearing due process as outlined in 42 C.F.R. § 431.200-246, as published in the October 1, 2006, Code of Federal Regulations.

Terms Used In Florida Regulations 64F-19.010

  • Fraud: Intentional deception resulting in injury to another.
    (2) Waiver applicants and clients shall receive written notice when a decision is made to deny or approve services under the Program. Written notice shall include at a minimum:
    (a) A description of the action the agency intends to take;
    (b) The reasons for the intended action;
    (c) Information about the waiver applicants or clients’ rights to request a hearing;
    (d) An explanation of the circumstances under which Medicaid services will continue if a hearing is requested;
    (e) A statement that requests for a hearing must be filed with the agency clerk within twenty-one (21) days of receipt of the written notice of agency action;
    (f) A statement that the hearing shall occur within ninety (90) days of the request; and,
    (g) A statement that the final order shall be entered within sixty (60) days of the hearing.
    (3) The hearings shall be conducted by the Department of Children and Families as outlined in Florida Statutes § 120.80(15)
    (4) Clients suspected of probable fraud shall have their period of advanced notice shortened to five (5) days before the date of action as prescribed in 42 C.F.R. § 431.214, effective as published in the October 1, 2006, Code of Federal Regulations.
Rulemaking Authority 154.011, 381.0011(13), 381.0051(7) FS. Law Implemented 154.011, 381.0051 FS. History-New 8-9-04, Amended 2-17-08.