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(1) A CYSHCN who has been denied eligibility for CSHS, a provider who has been denied reimbursement for services or covered benefits, or anyone who is otherwise adversely affected by denial for CSHS financial assistance may have informal reconsideration. The party requesting such a reconsideration must do so within 60 days after notice of the adverse action in question has been placed in the mail or otherwise communicated to the aggrieved party.

(2) A request for a reconsideration, in order to be considered, must be in writing, include refutation of the department's findings, and be postmarked no later than the 60th day after notice of the adverse action referred to in (1) was given.

(3) If the department receives a request for an informal reconsideration, it will conduct the reconsideration within 30 days after the date the request is received unless both the requestor and the department agree to a later date.

(4) An informal reconsideration will be conducted in accordance with the procedures prescribed for informal reconsideration in ARM 37.5.311, with the exceptions noted in (1) and (5). Such informal reconsideration is not subject to the provisions of the Montana Administrative Procedure Act, Title 2, chapter 4, MCA, or, except as provided in this rule, the provisions of ARM 37.5.304, 37.5.307, 37.5.310, 37.5.313, 37.5.316, 37.5.318, 37.5.322, 37.5.325, 37.5.328, 37.5.331, 37.5.334 and 37.5.337.

(5) In addition to the procedures specified in ARM 37.5.311, an applicant shall be provided an opportunity to appear and present evidence and arguments in person.

(6) The decision by the department after an informal reconsideration is final.


History: 50-1-202, MCA; IMP, 50-1-202, MCA; NEW, 1990 MAR p. 1256, Eff. 6/29/90; AMD, 1992 MAR p. 919, Eff. 5/1/92; AMD, 2000 MAR p. 1653, Eff. 6/30/00; TRANS, from DHES, 2001 MAR p. 398; AMD, 2003 MAR p. 1637, Eff. 8/1/03; AMD, 2018 MAR p. 1733, Eff. 8/25/18.

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