<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".02" citation="COMAR 10.01.04.02" title_num="10" subtitle_num="01" chapter_num="04" heading="Opportunity for a Fair Hearing.">
  <paragraph num="A.">
    <text>An opportunity for a fair hearing shall be granted if:</text>
    <paragraph num="(1)">
      <text>A Program applicant claims their application for Program eligibility is denied;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A Program applicant claims that the determination of eligibility received through Maryland Health Connection is incorrect;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A Program applicant claims their application for eligibility, or any part thereof, is not acted upon within:</text>
      <paragraph num="(a)">
        <text>30 days from the date of application to an insurance affordability program;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>45 days from the date of application for aged or blind applicants to the Program; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>60 days from the date of application to the Program in the case of determination of disability;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>A Program recipient asserts their claim for Program services has been erroneously denied or is not acted upon with reasonable promptness;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>A Program recipient asserts that the Program has acted erroneously;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>A Program recipient residing in a skilled nursing facility or nursing home asserts that the recipient has been or will be erroneously transferred or discharged;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>A Program recipient asserts that the Program has made an erroneous decision related to nursing home preadmission and annual review; or</text>
    </paragraph>
    <paragraph num="(8)">
      <text>A Program participant in an MCO is appealing an action by an MCO and the appeal has been filed within 120 days from the date specified in the notice from the MCO as required by COMAR 10.67.09.05.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The administrative law judge may not grant a fair hearing if the sole issue is a federal or State law requiring an automatic change adversely affecting some or all Program recipients.</text>
  </paragraph>
</regulation>