441—7.8(17A) Opportunity for hearing.
	7.8(1) Initiating an appeal. To initiate an appeal, a person, the person’s authorized representative or an individual or organization recognized by the department as acting responsibly for the person pursuant to policy governing a particular program must state in writing that the person disagrees with a decision, action, or failure to act on the person’s case.
	a. 	Food assistance, medical assistance, child care assistance and family investment program appeals may be made in person, by telephone or in writing as specified in subrule 7.8(2).
	b. 	 All other appeals, subject to paragraph 7.8(1)“a,” shall be made in writing.
	c. 	A written request may be submitted via the appeals section’s Web site or may be delivered by mail, electronic mail, facsimile transmission or personal delivery to the appeals section, to the local office, or to the department office that took the adverse action.
	d. 	A request by telephone or in person may be made to the appeals section or to the department office that took the adverse action.
	e. 	A Medicaid provider requesting a hearing on behalf of the member must have the prior express written consent of the member or the member’s lawfully appointed guardian, except when appealing a medical assistance eligibility determination. No hearing will be granted unless the provider submits a document providing the member’s consent to the request for a hearing.
	7.8(2) Filing the appeal. The appellant shall be encouraged, but not required, to make written appeal on Form 470-0487 or 470-0487(S), Appeal and Request for Hearing, and the worker shall provide any instructions or assistance required in completing the form. When the appellant is unwilling to complete or sign this form, nothing in this rule shall be construed to preclude the right to perfect the appeal, as long as the appeal is in writing (except for food assistance, medical assistance, child care assistance and family investment program appeals) and has been communicated to the department by the appellant or appellant’s representative.
A written appeal submitted by mail is filed on the date postmarked on the envelope sent to the department, or, when the postmarked envelope is not available, on the date the appeal is stamped received by the agency. When an appeal is submitted through an electronic delivery method, such as electronic mail, submission of an online form, or facsimile, the appeal is filed on the date it is submitted. The electronic delivery method shall record the date and time the appeal request was submitted. If there is no date recorded by the electronic delivery method, the date of filing is the date the appeal is stamped received by the agency. Receipt date of all appeals shall be documented by the office where the appeal is received.
	7.8(3) Informal conference. When requested by the appellant, an informal conference with a representative of the department or one of its contracted partners, including a managed care organization, shall be held as soon as possible after the appeal has been filed. An appellant’s representative shall be allowed to attend and participate in the informal conference, unless precluded by federal rule or state statute.
An informal conference need not be requested for the appellant to examine the contents of the case record, including any electronic case record, as provided in subrule 7.13(1) and 441—Chapter 9.
	7.8(4) Prehearing conference. When requested, a prehearing conference may be held with the appellant, a representative of the department and a presiding officer as soon as possible after the appeal has been filed. An appellant’s representative shall be allowed to attend and participate in the prehearing conference, unless precluded by federal rule or state statute.
	7.8(5) Interference. Neither an informal conference nor a prehearing conference shall be used to discourage appellants from proceeding with their appeals. The right of appeal shall not be limited or interfered with in any way, even though the person’s complaint may be without basis in fact, or because of the person’s own misinterpretation of law, agency policy, or methods of implementing policy.
	7.8(6) Right to deny or dismiss an appeal. The appeals section or the department of inspections and appeals has the right to deny or dismiss the appeal when:
	a. 	It has been withdrawn by the appellant pursuant to subrule 7.8(8).
	b. 	The sole issue is one of state or federal law requiring automatic grant adjustments for classes of recipients.
	c. 	It has been abandoned.
	d. 	The agency, by written notice, withdraws the action appealed and restores the appellant’s status that existed before the action appealed was taken.
	e. 	The agency implements action and issues a notice of decision or notice of action to correct an error made by the agency which resulted in the appeal.
Abandonment may be deemed to have occurred when the appellant, the appellant’s authorized representative, or the department fails, without good cause, to appear at the prehearing or hearing.
	7.8(7) Denial of due process. Facts of harassing, threats of prosecution, denial of pertinent information needed by the appellant in preparing the appeal, as a result of the appellant’s communicated desire to proceed with the appeal shall be taken into consideration by the administrative law judge in reaching a proposed decision.
	7.8(8) Withdrawal. When the appellant desires to voluntarily withdraw an appeal, the worker, the presiding officer, or the appeals section shall accept a request from the appellant to withdraw the appeal by telephone, in writing or in person. A written request may be submitted in person, by mail or through an electronic delivery method, such as electronic mail, submission of an online form, or facsimile. The appellant may use Form 470-0492 or 470-0492(S), Request for Withdrawal of Appeal, for this purpose. For child abuse and dependent adult abuse appeals, the request to withdraw an appeal must be made in writing and signed by the appellant or the appellant’s legal counsel.
	7.8(9) Department’s responsibilities. Unless the appeal is voluntarily withdrawn, the department worker or agent responsible for representing the department at the hearing shall:
	a. 	Within one working day of receipt of an appeal request, forward Form 470-0487 or 470-0487(S), Appeal and Request for Hearing, the written appeal, the postmarked envelope, if there is one, and a copy of the notification of the proposed adverse action to the appeals section.
	b. 	Forward a summary and supporting documentation of the worker’s or agent’s factual basis for the proposed action to the appeals section within ten days of the receipt of the appeal.
	c. 	Provide the appellant and the appellant’s representative copies of all materials sent to the appeals section or the presiding officer to be considered in reaching a decision on the appeal at the same time as the materials are sent to the appeals section or the presiding officer.
[ARC 8003B, IAB 7/29/09, effective 9/2/09; ARC 0487C, IAB 12/12/12, effective 2/1/13; ARC 0819C, IAB 7/10/13, effective 9/1/13; ARC 1261C, IAB 1/8/14, effective 3/1/14; ARC 3093C, IAB 6/7/17, effective 7/12/17]