---
kind: "section"
citation: "42 C.F.R. § 431.206"
title: "42"
number: "431.206"
heading: "Informing applicants and beneficiaries."
url: "https://uscodex.org/cfr/42/431.206"
---

# §431.206. Informing applicants and beneficiaries.

- (a) The agency must issue and publicize its hearing procedures.
- (b) The agency must, at the time specified in [paragraph (c)](#c) of this section, inform every applicant or beneficiary in writing—
  - (1) Of his or her right to a fair hearing and right to request an expedited fair hearing;
  - (2) Of the method by which he may obtain a hearing;
  - (3) That he may represent himself or use legal counsel, a relative, a friend, or other spokesman; and
  - (4) Of the time frames in which the agency must take final administrative action, in accordance with [§ 431.244(f)](/cfr/42/431.244.md?p=f).
- (c) The agency must provide the information required in [paragraph (b)](#b) of this section—(1) At the time that the individual applies for Medicaid;
  - (2) At the time the agency denies an individual's claim for eligibility, benefits or services; or denies a request for exemption from mandatory enrollment in an Alternative Benefit Plan; or takes other action, as defined at [§ 431.201](/cfr/42/431.201.md); or whenever a hearing is otherwise required in accordance with [§ 431.220(a)](/cfr/42/431.220.md?p=a);
  - (3) At the time a skilled nursing facility or a nursing facility notifies a resident in accordance with [§ 483.15](/cfr/42/483.15.md) of this chapter that he or she is to be transferred or discharged; and
  - (4) At the time an individual receives an adverse determination by the State with regard to the preadmission screening and annual resident review requirements of [section 1919(e)(7)](/cfr/42/1919.md?p=e-7) of the Act.
- (d) If, in accordance with [§ 431.10(c)(1)(ii)](/cfr/42/431.10.md?p=c-1-ii), the agency has delegated authority to the Exchange or Exchange appeals entity to conduct the fair hearing, the agency must inform the individual in writing that—
  - (1) He or she has the right to have his or her hearing before the agency, instead of the Exchange or the Exchange appeals entity; and
  - (2) The method by which the individual may make such election;
- (e) The information required under this subpart must be accessible to individuals who are limited English proficient and to individuals with disabilities, consistent with [§ 435.905(b)](/cfr/42/435.905.md?p=b) of this chapter, and may be provided in electronic format in accordance with [§ 435.918](/cfr/42/435.918.md) of this chapter.

## Notes

### Amendments

[44 FR 17932, Mar. 29, 1979, as amended at 57 FR 56505, Nov. 30, 1992; 58 FR 25784, Apr. 28, 1993; 78 FR 42301, July 15, 2013; 81 FR 68847, Oct. 4, 2016; 81 FR 86448, Nov. 30, 2016]

### Source

Source: 44 FR 17932, Mar. 29, 1979, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45188, Sept. 29, 1978, unless otherwise noted.

### Amendments

[44 FR 17932, Mar. 29, 1979, as amended at 57 FR 56505, Nov. 30, 1992; 58 FR 25784, Apr. 28, 1993; 78 FR 42301, July 15, 2013; 81 FR 68847, Oct. 4, 2016; 81 FR 86448, Nov. 30, 2016]