Cal. Code Regs. Tit. 9, § 1850.208 - The Expedited Appeal Process

In addition to meeting the requirements of Section 1850.205 and 1850.207(a), (d), (e), (f), (g), and (i), the expedited appeal process shall, at a minimum:

(a) Be used when the MHP determines or the beneficiary and/or the beneficiary's provider certifies that taking the time for a standard appeal resolution could seriously jeopardize the beneficiary's life, health or ability to attain, maintain, or regain maximum function.

(b) Allow the beneficiary to file the request for an expedited appeal orally without requiring that the request be followed by a written appeal.

(c) Ensure that punitive action is not taken against a beneficiary or a provider because they request an expedited appeal or support a beneficiary's request for an expedited appeal.

(d) Resolve an expedited appeal and notify the affected parties in writing, no later than three working days after the MHP receives the appeal. This timeframe may be extended by up to 14 calendar days if the beneficiary requests an extension, or the MHP determines that there is need for additional information and that the delay is in the beneficiary's interest. If the MHP extends the timeframes, the MHP shall, for any extension not requested by the beneficiary, notify the beneficiary of the extension and the reasons for the extension in writing. The written notice of the extension is not a Notice of Action as defined in Section 1810.230.5.

(e) Provide a beneficiary with a written notice of the expedited appeal disposition and make reasonable efforts to provide oral notice to the beneficiary and/or his or her representative. The written notice shall meet the requirements of Section 1850.207(h).

(f) If the MHP denies a request for expedited appeal resolution, the MHP shall:

(1) Transfer the expedited appeal request to the timeframe for appeal resolution as required by Section 1850.207(c).

(2) Make reasonable efforts to give the beneficiary and his or her representative prompt oral notice of the denial of the request for an expedited appeal and provide written notice within two calendar days of the date of the denial. The written notice of the denial of the request for an expedited appeal is not a Notice of Action as defined in Section 1810.230.5.

Notes

Cal. Code Regs. Tit. 9, § 1850.208

1. New section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20).

Note: Authority cited: Section 14680, Welfare and Institutions Code. Reference: Section 14684, Welfare and Institutions Code; and Title 42, Code of Federal Regulations, Part 438, Subpart F.

1. New section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20).