The bill proposes the repeal of sections 208.080 and 208.156 of the Revised Statutes of Missouri (RSMo) and enacts two new sections in their place, which focus on administrative remedies in MO HealthNet cases. The new language expands the scope of appeal rights for applicants and recipients of benefits or services provided by the family support division, children's division, and the MO HealthNet division, now including the Missouri Medicaid audit and compliance unit. It allows individuals to appeal decisions regarding the denial of applications, disallowance of benefits, and proposed modifications or cancellations of services. Additionally, it establishes a clear process for appealing decisions, including timelines for requests and the continuation of benefits during the appeal process. The new provisions also outline the rights of service providers regarding reimbursement claims and participation in programs, ensuring they have the opportunity for a fair hearing if their claims are denied or not acted upon promptly. The bill includes specific requirements for the administrative hearing commission, such as the need for a fair hearing and the ability for providers to represent others with similar claims. Furthermore, it introduces a requirement for a bond when seeking a stay order, while removing previous restrictions related to federal funding. Overall, the bill aims to enhance the administrative remedy process for individuals and providers involved in Missouri's health and social services programs.

Statutes affected:
Introduced (6218H.01): 208.080, 208.156