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ELIGIBILITY-decisions concerning the denial or termination of Food Stamps, Work First or Medicaid are generally covered by N.C. Gen. Stat. 108A-79. Appeals must be made within 10 days of notice to maintain benefits. Otherwise, appeals must be made within 60 days (90 days for Food Stamps). There are three levels of review:
Local reviews are generally simple hearing (conferences in Food Stamp cases) before an employee of the department that made the decision. In many instances, the reviews uphold the original decision. Appeals from these decisions must be made within 15 days of the DATE of the decision. State appeals are conducted by State Hearing Officers. These are de novo hearings held after the local hearing decision. The hearings are conducted under oath and are recorded. It is this hearing that produces the record that can be reviewed by Superior Court. Either side can ask that the chief hearing officer in Raleigh to review the tentative decision of the hearing officer. NOTE that in Work First electing counties, the county is responsible for the creation of a hearing process that is similar to this process but the county cannot use State Hearing Officers. Appeals from these decision must be made within 30 days of RECEIPT of the decision. Superior Court reviews are conducted to determine whether the State Hearing process was conducted properly. Generally, no additional evidence is taken at this level. SERVICE DENIALS OR TERMINATIONS--when Medicaid or its agents deny, reduce or terminate a covered Medicaid service, appeals are conducted under 10A N.C.A.C. 22H. These are administrative hearings that differ substantially from the 108A process. Medicaid does allow for an informal reconsideration process before the agency. The actual administrative hearing process is conducted by the Office of Administrative Hearings. Appeals must be made within 60 days of notice of the decision. |
