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General Laws

Section 48. There shall be within the division a board of hearings for the purpose of holding the hearings referred to herein and rendering decisions. Said board shall be under the supervision of a director appointed by the commissioner and shall be independent of all other subdivisions and personnel of the division.

Any person aggrieved by the failure of the division to render adequate medical assistance under any program of medical assistance administered by the division or to approve or reject an application for medical assistance thereunder within forty-five days after receiving such application, or aggrieved by the withdrawal of such assistance, or by coercive or otherwise improper conduct on the part of his or her social worker, shall have a right to a hearing, after due notice, upon appeal to the commissioner.

A hearing held pursuant to this section shall be conducted by a referee designated by the director at a location convenient to the person appealing and shall be conducted as an adjudicatory proceeding under chapter thirty A. The director of the board of hearings shall be responsible for the fair and efficient operation of the board in conformity with state and federal laws and regulations and for the training of referees, scheduling of hearings and the compilation of decisions. Neither the director nor any other employee of the division shall review, interfere with, change or attempt to influence any hearing decision by a referee. A referee may subpoena witnesses, administer oaths, take testimony and secure the production of such books, papers, records and documents as may be relevant to such hearing. The person appealing shall have the opportunity to confront and cross-examine all adverse witnesses and to question or refute any testimony, evidence, materials, or legal arguments. The referee shall base his or her decision solely on the testimony, evidence, materials and legal rules adduced at the hearing. The referee may reopen a hearing for the purpose of considering further testimony, evidence, materials or legal rules before rendering his or her decision and shall, if he or she reopens the hearing, send seven days’ written notice to all parties of the reopening and the reasons therefor, including the date, time and place of the resumed hearing, which shall be held at a location convenient to the person appealing. The decision of the referee shall be the decision of the division.

A referee shall render and issue a decision within ninety days after the date of the filing of the aggrieved person’s appeal, except that when an aggrieved person appeals the rejection of his or her application for medical assistance, or the failure to act on said application, or the failure of the division to render emergency medical assistance, the referee shall render and issue a decision within forty-five days after the date of filing of said appeal. The decision of the division shall be subject to review in accordance with the provisions of chapter thirty A.

When a hearing is requested because of termination or reduction of assistance, involving an issue of fact, or of judgment relating to the individual case, between the agency and the appellant, assistance will be continued during the period of the appeal and through the end of the month in which the final decision on the hearing is reached. If assistance has been terminated prior to timely request for fair hearing, assistance will be reinstated.

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