(BOC) Receives appeal request and conducts a pre-hearing review for AABD cases, when a decision to file a lien on real property owned by an AABD medical long term care client is appealed.
- (FCRC) For pre-hearing review, use information on the daily list of centrally issued client notices (see WAG 01-06-00) to verify:
- (FCRC) Notify the client in writing if the Department's action is reversed or modified.
- Send a timely corrected Notice of Change (Form 157) or an approval/denial notice, if the decision is to modify the original action.
- If the decision is to reverse the action on an active case, send the client a Notice of Benefit Restoration (Form 3363).
- Attach Request to Withdraw Appeal (Form 65) to the notice, and include a letter requesting that the client sign and return Form 65.
- (FCRC) Ensure that all necessary documentation or proofs required to proceed with the appeal are in hand if the client does not withdraw the appeal.
- (FCRC) Contact the appropriate bureau and attempt to get information if more documents or clarification is needed in order to proceed with the appeal.
Note: For appeals related to overpayments ensure all necessary documents are included in the overpayment packet. Request any client notices from the Bureau of Collections (BOC).
- (FCRC) Contact the proper central office contact person if the issue involves complex collections, cross-match, special investigations' policies or practices, or genuineness of a signature.
- (Casework Supervisor) After the pre-hearing review, document the review results on Appeal Control Card and Pre-Hearing Review Quality Checklist (Form 1201), and sign the form.
- Use the back of the form during the pre-hearing review to document and determine if action taken was timely and appropriate.
- Use the front of the form to document action taken on the appeal.
- (Casework Supervisor) Forward the completed Form 1201 to the Appeal Coordinator.