Update
Support Extending the Medicaid Eligibility Appeal Timeline and Providing Additional Mailing Time for Appeals
SUPPORT: HB 1240 (Del. Willett)
Published / By Emily Hardy, Esq.
Appeals allow benefit recipients and applicants to challenge a wrong decision or resolve an issue in order to maintain their benefits.
Virginia’s public benefits appeal time limits are inconsistent. Different appeal time limits apply for different public benefits, including SNAP and Medicaid, which is confusing for workers and Medicaid recipients. In addition, U.S. Postal Service mail delays affect the ability of benefit recipients to meet appeal deadlines.
Virginia’s Medicaid appeal time limit is below the federally allowed maximum and inconsistent with other public benefits time limits. HB 1240 resolves these issues:
Extends Medicaid state fair hearing eligibility time limit to 90 days.
Current Virginia law allows a 30-day appeal time limit (12VAC30-110-160), which is the minimum.
Many states, including Maryland (90 days), allow longer appeal time limits. Virginia should also adopt a 90-day appeal time limit.
Aligns with existing benefit time limits.
Current Virginia regulations allow a 90-day appeal time limit for SNAP benefit appeals, and Medicaid allows a 90-day reconsideration period.
Increasing the appeal limit aligns all three processes and ensures individuals do not confuse which time limit applies.
Postmark and mail delays harm vulnerable communities’ ability to appeal wrong decisions. HB 1240 offsets these delays:
Extends the mailing time to 10 days for any deadline associated with Medicaid, SNAP, or TANF notices.
- Virginia ranks among the bottom ten states for timely mail deliveries, yet staff primarily use mail to communicate with applicants and beneficiaries.
- Mail delays impact individuals' ability to file timely appeals.
- LDSS directors noted these delays are in part a result of mail system processes. For instance, centralized VDSS mail goes to Lynchburg for printing but is then sent out of state to Greensboro, NC for sorting and mailing.
Historically, postmarks have been applied the same day an item is received. However, the U.S. Postal Service no longer guarantees the postmark date is the date they received the mail.
This bill also helps offset the harm from postmarks no longer being proof that a request for an appeal for public benefits was turned in by a legal deadline.
HR.1’s six month renewals and work reporting requirements make these appeal updates urgent as Medicaid expansion recipients will soon face double the number of bureaucratic hurdles and additional paperwork requirements to access healthcare.
