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:

  1. (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.
  2. (LO/Other) Send original Form 1456 to the Bureau of Assistance Hearings with a copy of the new decision summary.
  3. (LO/Other) For dental or other medical services where the decision is not upheld, Bureau of Comprehensive Health Services (BCHS) completes Form 1456.
  4. (LO/Other) For payment of health insurance premiums through the HIPP Program where the decision is not upheld, the HIPP Unit completes Form 1456. 
  5. (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).
  6. (LO/Other) For child care, BCCD completes Form 1456.
  7. (LO/Other) File a copy of Form 1456 and the decision summary in the case record.

Examples of Follow-up on Actions Not Upheld

Example 1: Client appealed a notice of overpayment. The Final Administrative Decision does not uphold the Family Community Resource Center because, although an overpayment exists, the amount was incorrect.

Recalculate the overpayment and send the client a revised locally issued Form 2404X. Complete Form 2404C and hold for 10 calendar days.

If a request for a hearing is not filed within the 10-day period, forward Form 2404C and Form 2404X to BOC.

Complete Form 1456 and send the original to BAH. File a copy in the case record.

Example 2: Client appealed a notice of reduced cash benefits due to budgeting of unearned income.

The Final Hearing Decision advised the office to recalculate the reduction. Recalculate the reduction, and:

  • (for TANF): process the action via Form 552 or through ACM, which generates the centrally issued Form 157C and Form 553H notifying the client of the change;

(for AABDtext deleted): notify the client in writing of the change.

Complete Form 1456 and send the original to BAH. File a copy in the case record.