HA 3.03(1)(d)(d) The determination of the amount, sufficiency, initial eligibility date of program benefits excluding COP program benefits.

HA 3.03(1)(f)(f) For the COP program and medicaid waiver services, the denial of eligibility for services or reduction or termination of services as provided in s. 46.27 (7m), Stats.

HA 3.03(1)(g)(g) A determination with regard to the preadmission screening and annual resident review requirements of section 1919(e)(7) of the Social Security Act of 1935, as amended.

HA 3.03(1)(h)(h) A decision to transfer or discharge a resident from a facility subject to the requirements of 42 CFR 483.12.

HA 3.03(1)(i)(i) A denial or termination of eligibility for medicaid under the Katie Beckett waiver program under section 1902(e)(3) of the Social Security Act.

HA 3.03(1)(j)(j) A decision to impose a medicaid lien or to deny a hardship waiver under s. 49.496, Stats.

HA 3.03(1)(k)(k) Any other decision or action affecting a medicaid applicant or enrollee where a hearing is required by law.

HA 3.03(1)(L)(L) A decision to deny a hardship waiver under s. 49.682 (5), Stats., with regard to the recovery of benefits under a chronic disease program.

HA 3.03(1)(m)(m) The determination under s. 49.85, Stats., to recover an overpayment of benefits by means of certification to the Wisconsin department of revenue and the determination of the amount of such an overpayment as including an amount they believe has already been repaid or discharged in bankruptcy.

HA 3.03(1)(n)(n) A denial of an application for kinship care payment on the grounds specified in s. 48.57 (3m) (am) 1., 2., 4., 4m. and 5., Stats., or the termination of kinship care payments.

HA 3.03(1)(o)(o) Removal of a child or any other decision or order by an agency or department that affects the head of a foster, treatment foster or group home or the children involved, per s. 48.64 (4), Stats.

HA 3.03(2)(2) An applicant for or recipient of medicaid may appeal a decision or order of a managed care entity which denies, reduces, terminates or otherwise limits services, which denies an enrollee’s request for disenrollment or exemption from the entity or which otherwise adversely affects the individual.

HA 3.03(3)(3) A former recipient of medicaid, food stamps, aid to families with dependent children or W-2 may appeal the determination that he or she has been overpaid benefits, the amount of such an overpayment still owing or whether it has been discharged in bankruptcy or the determination under s. 49.85, Stats., to recover such an overpayment by means of certification to the Wisconsin department of revenue.

HA 3.03(4)(4) An applicant, recipient or former recipient may appeal any other adverse action or decision by an agency or department which affects their public assistance or social services benefits where a hearing is required by state or federal law or department policy.

HA 3.04HA 3.04 Notification of right to appeal. An agency or department shall in writing inform a person at the time the person applies for medicaid, food stamps, public assistance or social services, and at the time an agency takes an action listed under s. HA 3.03, of the person’s right to a hearing under this chapter and of procedures for requesting a hearing as set forth in s. HA 3.05.

HA 3.05(1)(1) An applicant or recipient who wishes to contest an action specified under s. HA 3.03 may request a hearing.

HA 3.05(2)(2) A request for a hearing may be made by the applicant, recipient or former recipient, by an immediate family member, or someone with legal authority to act on their behalf. The division in its discretion may require written authorization of such representation in an individual case or a type of case.

HA 3.05(2)(a)(a) A request for a hearing may be made in writing or orally and may be made to the agency or the division. An oral request to the agency shall be reduced to writing by the agency and signed by the petitioner, except that a request involving only food stamps need not be signed. An agency receiving a hearing request shall immediately date-stamp the request and forward it to the division.

HA 3.05(2)(b)(b) The hearing request shall include a short statement of the matter to be reviewed. If it is unclear from the request what action the person seeks to appeal or whether the petitioner has standing to obtain a hearing, the division may request clarification before taking action on the request.

HA 3.05 NoteNote: A hearing request should be addressed to the Division of Hearings and Appeals, P.O. Box 7875, Madison, Wisconsin 53707. Appeals may be delivered in person to that office at 5005 University Avenue, Room 201, Madison, Wisconsin.

HA 3.05(3)(3) Except as provided in par. (a) or (b), the petitioner shall have 45 days from the effective date of the adverse action specified under s. HA 3.03 in which to file a hearing request.

HA 3.05(3)(a)(a) For a hearing request relating to food stamps, the petitioner has 90 days from the date of the action specified under s. HA 3.03 in which to file the hearing request.

HA 3.05(3)(b)(b) If a different time limit for a hearing request is specified by state statute, administrative rule or federal regulation, that limit shall apply and shall be stated in the notification of Right to Appeal in the decision.

HA 3.05(3)(c)(c) A hearing request shall be considered filed on the date of actual receipt by the division or agency, or the date of the postmark, whichever is earlier. A request filed by facsimile is complete upon transmission. If the request is filed by facsimile transmission and such transmission is completed between 5 p. m. and midnight, 1 day shall be added to the prescribed period.

HA 3.05(4)(4) The division shall deny or dismiss a hearing request under any of the following circumstances: