36-2979.07. Grievance and appeal process

(Conditionally Rpld.)

A. A member or applicant aggrieved by an action of the administration or a contractor relating to eligibility, enrollment or services under this article has the right to file a grievance or appeal pursuant to section 36-3413 and, if applicable, to a hearing pursuant to rules adopted pursuant to section 36-2903.01, subsection B.

B. The contractor's grievance and appeal process required under section 36-3413 applies to matters arising under this article, including denials, reductions or terminations of enhanced residential treatment services and contractor clinical eligibility determinations.

C. Appeals of financial eligibility determinations made by the administration pursuant to section 36-2979.02, subsection B shall be heard pursuant to rules adopted pursuant to section 36-2903.01, subsection B.