FAQ on Appeals
Q. I disagree with the county MATP, what can I appeal?
Q. What is the definition of a denial?
Q. What if I am already receiving services and the county wants to change my transportation?
Q. How do I appeal?
Q. What is the deadline for filing an appeal?
Q. What will the county MATP do with my appeal?
Q. I disagree with the county MATP, what can I appeal?
Consumers may appeal written notice forms of denials of service. County MATPs must give a consumer a written notice any time a request for service is denied, terminated or reduced; the only exceptions are described below.
Here is what the notice form will look like and the county has to fill it out completely. Consumers must also be given a CAO Referral Form so that the consumer can go to the CAO to request transportation assistance.
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Q. What is the definition of a denial?
A denial is any time:
- a trip has been requested and no trip has been authorized, or
- an MATP application has not been accepted, or
- the transportation requested is not to a medical facility as defined by MATP, or
- the consumer has not provided requested documentation for purposes of obtaining mileage reimbursement, or
- the agency is unable to provide the services, or
- where a consumer asserts that the mode assigned by MATP is not appropriate to her or her needs, or
- where the consumer has requested a mode that has not been approved
- where the consumer has requested a trip but declines to complete the county’s assessment or verification process
Exception: A written notice is not required when
- the trip is denied because the consumer is not eligible for MA, or
- the requested destination is not a medical service
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Q. What if I am already receiving services and the county wants to change my transportation?
If the consumer is being terminated or suspended from the program the notice must specify the effective date and must be sent at least fifteen days prior to the effective date. If the consumer files an appeal within ten days the services will continue while the appeal is being reviewed.
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Q. How do I appeal?
Consumers may appeal the written notice orally or in writing to the county MATP office. If the appeal is oral, the MATP must write the appeal down and have the consumer sign the appeal.
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Q. What is the deadline for filing an appeal?
Consumers have 30 days from the mailing date of the written notice to appeal. If the appeal is related to a change to ongoing services, the consumer must appeal within 10 days in order for the services to continue while the appeal is under review.
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Q. What will the county MATP do with my appeal?
The county MATP will forward your appeal to the Bureau of Hearings and Appeals within three business days. The county will also send a copy to the DHS MATP office.
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