Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 7 - Appeals and Hearings › Rule 441-7.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Adverse benefit determination"
means any
				  adverse action taken as to any individual's benefits pursuant to an assistance
				  program administered by the department or on the department's behalf, excluding
				  determinations related to requests for exceptions to policy.
"Appeals section"
means the section of the
				  department charged with administering the department's appeals.
"Appellant"
means a person, including an
				  authorized representative acting on the person's behalf, seeking to appeal some
				  action pursuant to this chapter.
"Assistance program"
means a program
				  administered by the department or on the department's behalf through which
				  qualifying individuals receive benefits or services. Assistance programs
				  include, but are not necessarily limited to, the Supplemental Nutrition
				  Assistance Program (SNAP), Medicaid, the family investment program, refugee
				  cash assistance, child care assistance, emergency assistance, the family
				  planning program, the family self-sufficiency program, PROMISE JOBS, state
				  supplementary assistance, the healthy and well kids in Iowa (hawki) program,
				  foster care, adoption, and aftercare services.
"Authorized representative"
means a person
				  lawfully designated by an individual to act on the individual's behalf or who
				  has legal authority to act on behalf of the individual.
"Contested case"
refers to an evidentiary
				  hearing mandated by state or federal constitutional or statutory authority
				  whereupon a presiding officer makes a determination pertaining to the relative
				  rights and obligations of parties to an appeal under this chapter.
"DIAL"
means the department of inspections,
				  appeals, and licensing.
"Enrollee"
means any applicant to or
				  recipient of benefits or services pursuant to an assistance program.
"Good cause,"
for purposes of this rule,
				  shall have the same meaning as "good cause" for setting aside a default
				  judgment under Iowa Rule of Civil Procedure 1.977.
"In-person hearing"
means an appeal hearing
				  where the administrative law judge and appellant are physically present in the
				  same location but witnesses are not required to be physically present.
"Intentional program violation"
means
				  deliberately making a false or misleading statement; or misrepresenting,
				  concealing, or withholding facts; or committing any act that is a violation of
				  the Supplemental Nutrition Assistance Program (SNAP), SNAP regulations, or any
				  state law relating to the use, presentation, transfer, acquisition, receipt,
				  possession, or trafficking of SNAP benefits or an electronic benefit transfer
				  (EBT) card. An intentional program violation is determined through a SNAP
				  administrative disqualification hearing, a court conviction, or when an
				  individual signs and returns Form 470-5530, Waiver of Right to an
				  Administrative Disqualification Hearing, which may result in a period of
				  ineligibility for the program, a claim for overpayment of benefits, or
				  both.
"Issuance"
means the date of mailing of a
				  decision or order or date of delivery if service is by other means unless
				  another date is specified in the order.
"Managed care organization"
or
"MCO"
has the meaning assigned to it in rule
				  441-73.1 (249A) and includes
				  prepaid ambulatory health plans.
"Medicaid"
means Iowa's medical assistance
				  program administered under Iowa Code chapter 249A.
"Party-in-interest"
refers to the party,
				  including enrollees, whose rights or obligations are the subject of a contested
				  case hearing under this chapter. Parties-in-interest may or may not be the
				  appellant.
"Presiding officer"
means an administrative
				  law judge from DIAL or the director of the department or the members of a
				  multimember board or commission.
"Self-represented"
means representing
				  oneself without an attorney.