SHMTL 37-A (State Hearings- Five-Year Rule Review (Package 1))
State Hearings Manual Transmittal Letter No. 37-A
March 21, 2019
TO: All State Hearings Manual Holders
FROM: Kimberly Hall, Director
SUBJECT: State Hearings- five-year rule review (package 1)

This SHMTL contains amended, rescinded and new division 5101:6 Administrative Code rules as a result of a five-year rule review. These rules are effective 3/1/19. Rescinded and new rule 5101:6-2-32 were refiled and are effective 4/1/19.

5101:6-1-01 "State hearings: general." This rule describes the general hearing and appeal rights and procedures applicable to family services program benefits. The rule also provides general definitions applying to Chapters 5101:6-1 through 5101:6-9 of the Administrative Code. This rule is being rescinded and created as new to reorganize the rule content. Changed “food assistance” to “supplemental nutrition assistance program (SNAP).” In paragraph (F)(11)(c), changed the reference to “5101:2-25.” Made other grammatical changes.

5101:6-2-01 "State hearings: notice at the time of application." This rule states that an assistance group is to be notified at the time of application of its right to a state hearing and describes the method by which such notice shall be given. The rule is being amended to: change “food assistance” to “supplemental nutrition assistance program (SNAP)” and update the revision date of the JFS 04059 form.

5101:6-2-02 "State hearings: notice of approval of an application for benefits." This amended rule states that an assistance group is notified when its application for benefits has been approved and describes the method by which such notification shall be given. This rule is being amended to: change “food assistance” to “supplemental nutrition assistance program (SNAP)” and update the name and revision date of the JFS 07401 form. Also, reorganized paragraph (A).

5101:6-2-03 "State hearings: notice of denial of an application for benefits." This rule states that an assistance group is notified when its application for benefits has been denied and describes the method by which such notification shall be given. This rule is being rescinded and created as new to reorganize the rule content. Changed “food assistance” to “supplemental nutrition assistance program (SNAP).” Made other grammatical changes. Paragraph (B)(5) was updated.

5101:6-2-04 "State hearings: prior notice of adverse action." This rule states that an assistance group shall receive prior notification when adverse action is proposed by the local agency. The rule also describes the method by which such notification shall be given. This rule is being amended to: change “food assistance” to “supplemental nutrition assistance program” (SNAP) and reorganize paragraph (B).

5101:6-2-05 "State hearings: exceptions to prior notice." This rule describes the exceptions to prior notice of proposed adverse action. This rule is being amended to: change “food assistance” to “supplemental nutrition assistance program (SNAP),”update the revision date of the JFS 04085 form, reorganize paragraph (A)(2) and make other grammatical changes. Updated paragraphs (A)(1) and (A)(1)(b).

5101:6-2-06 "State hearings: notice of mass change in benefits." This rule states that an assistance group shall receive prior notice when a mass change will require an automatic adjustment of benefits, and the rule describes the method by which such notification shall be given. This rule is being amended to: change “food assistance” to “supplemental nutrition assistance program (SNAP)”, reorganize paragraph (A)(2) and make other grammatical changes.

5101:6-2-07 "State hearings: notice of the right to a state hearing - child support services." This amended rule states the notifications an assistance group receives from child support services (right to hearing, application acceptance or denial, termination of support order, and case closure), and the rule describes the method by which such notification shall be given. Changes to the rule include: updated the revision date of the JFS 04059 form and made other grammatical changes.

5101:6-2-08 "State hearings: notice whenever disagreement with an action or inaction is expressed." This rule states that an assistance group is reminded to request a hearing and/or provided a new application when disagreement with action or inaction is expressed. This rule is being amended to correct the revision date and name of the JFS 04059 form and reworded paragraph (B).

5101:6-2-20 "State hearings: notice of overpayment/overissuance." This rule states that an assistance group is notified when the local agency has determined there was an overpayment/overissuance and describes the method by which such notification shall be given. This rule is being amended to change “food assistance” to “supplemental nutrition assistance program (SNAP).” Also, reformatted the rule.

5101:6-2-25 "State hearings: notice of eligibility for lost supplemental nutrition assistance program (SNAP) benefits." This rule states that an assistance group is notified when a loss of SNAP benefits has occurred and describes the method by which such notification shall be given. This rule is being rescinded and created as new to reorganize the rule content. Updated the title of the rule and changed “food assistance” to “supplemental nutrition assistance program (SNAP).”

5101:6-2-26 "State hearings: notice of approval, denial or delay of replacement supplemental nutrition assistance program (SNAP) benefits." This rule states that an assistance group is notified when its request for replacement benefits has been approved, denied, or delayed and describes the method by which such notification shall be given. This rule is being amended to update the title of the rule and change “food assistance” to “supplemental nutrition assistance program (SNAP).” Also, reorganized paragraph (B).

5101:6-2-30 "State hearings: notice of medical determination." This amended rule describes the process in which a notice of a medical determination will be sent to an individual or their authorized representative. The rule explains the situations in which a notice is sent and contains the information included in that notice. Minor, grammatical changes were made to the rule and paragraph (B) was reorganized for clarity.

5101:6-2-31 "State hearings: notice of denial of prior authorization for medical or dental services." This amended rule governs the process for sending notification of denial to an individual who has requested prior authorization of medical or dental services. The rule explains who receives the notification and what information the notification contains. Reorganized paragraph (A).

5101:6-2-32 "State hearings: notice of adverse preadmission screening and resident review (PASSR) determinations." This rule governs the process for sending notices for adverse preadmission screenings and resident review determinations. It describes what is contained in each notice, who receives the notice, and how the notice is delivered. This rule is being rescinded and created as new to reorganize the rule content. This rule was refiled to remove the PASSPORT waiver wording in paragraphs (A) and (A)(2)(c).

5101:6-2-36 "State hearings: notice of denial of just cause request for termination of managed care plan's membership." This amended rule governs the process for sending notices of denial of a just cause request for termination of a managed care plan's membership. The rule explains why this notice is sent and what information is contained in the notice. Minor, grammatical changes were made to the rule.

5101:6-2-40 "State hearings: coordinated services program state hearing and notice requirements." This amended rule sets forth the hearing process for the Medicaid "Coordinated Services Program" (CSP). The rule includes hearing and notice rights associated with proposed enrollment into the CSP, continued enrollment into the CSP, and denial of a designated provider change. Paragraph (C)(1) was reworded for clarity.