West Virginia Code 9-8-7 – Notice and right to be heard
(a) An applicant shall be given written notice and the opportunity to explain any issues with the application or redetermination as set forth in § 9-8-6 of this code. Self-declarations by applicants or recipients shall be accepted as verification of categorical and financial eligibility if no other verification source is available. In cases requiring expedited services an applicant’s statement may be temporarily accepted until such time as verification is possible.
Terms Used In West Virginia Code 9-8-7
- Assistance: means the three classes of assistance, namely: Federal-state assistance, federal assistance and state assistance. See West Virginia Code 9-1-2
- Department: means the West Virginia Department of Health and Human Resources. See West Virginia Code 9-8-1
- in writing: includes any representation of words, letters, or figures, whether by printing, engraving, writing, or otherwise. See West Virginia Code 2-2-10
- recipient: means a person who is applying for, or currently receiving, public assistance in the State of West Virginia from the department. See West Virginia Code 9-8-1
- Services: means nursing facility services, home and community-based services, and related hospital and prescription drug services for which an individual received Medicaid medical assistance. See West Virginia Code 9-1-2
(b) The notice given to the applicant or recipient is required to describe the circumstances of the issue, the manner in which the applicant or recipient may respond, and the consequences of failing to take action. If the applicant does not respond timely as required by federal law, the department shall take appropriate action. The department may request additional information as it finds necessary to reach a decision.
(c) An individual may respond in writing, electronically, or verbally. If an individual responds verbally, staff shall note the time and contents of the response in the individual’s file. The response by the individual may:
(1) Disagree with the findings of the department. The department shall reinvestigate the matter if the applicant or recipient disagrees. If the department finds that there has been an error, the department shall take immediate action to correct it. If the department determines that there is no error, the department shall determine the effect of the response on the applicant’s or recipient’s case and take appropriate action. Written notice of the department’s action shall be given to the applicant or recipient; or
(2) Agree with the findings of the department. The department shall determine the effect on the applicant’s or recipient’s case and take appropriate action. Written notice of the department’s action shall be given to the applicant or recipient.
(d) If the applicant fails to respond to the notice, the department shall deny or discontinue assistance for failure to verify information. Eligibility for assistance may not be established or reestablished until the issue has been resolved.