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Implementation Guide: Eligibility Determinations and Fair Hearings

Guidance for the reviewable unit (RU) document that describes how the single state agency effectuates its responsibility for Medicaid eligibility determinations and fair hearings as required at 42 CFR 431.10(b)(3). It includes options to indicate whether the Medicaid agency conducts determinations of eligibility and fair hearings directly or through other governmental agencies or local governmental entities.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 01, 2020

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.