137.01 Administrative Appeal Requests and the ANP (MAM)

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If an individual requests an administrative appeal within 15 days of the date on the notice being appealed, continue medical assistance at the pre-change level pending the decision on the appeal. If an individual requests an appeal after the 15-days expire or if there is no ANP, the termination or decrease takes effect on schedule. The individual may choose to continue receiving medical assistance at the pre-change level pending the outcome of an administrative appeal.

If the appeals officer agrees that the Department's action was correct, the recipient household will owe the Department the value of the extra medical assistance benefits that were received, including any Medicaid Care Management per member/per month premiums that were paid, as a result of the continued benefits.