10A NCAC 22J .0103        RECONSIDERATION REVIEW PROCESS

(a)  Upon receipt of a timely request for a reconsideration review, the Deputy Director shall appoint a reviewer or panel to conduct the review.  DMA will arrange with the provider a time and date of the hearing.  The provider must reduce his arguments to writing and submit them to DMA no later than 14 calendar days prior to the review.  Failure to submit written arguments within this time frame shall be grounds for dismissal of the reconsideration, unless the Division within the 14 calendar day period agrees to a delay.

(b)  The provider will be entitled to a personal review meeting unless the provider agrees to a review of documents only or a discussion by telephone.

(c)  Following the review, DMA shall, within 30 calendar days or such additional time thereafter as specified in writing during the 30 day period, render a decision in writing and send it by certified mail to the provider or his representative.

 

History Note:        Authority G.S. 108A‑25(b); 108A‑54; 150B‑11; 42 U.S.C. 1396(b);

Eff. January 1, 1988;

Pursuant to G.S. 150B-33(b)(9), Administrative Law Judge Augustus B. Elkins, II declared this rule void as applied in Psychiatric Solutions, Inc., d/b/a/ Holly Hill Hospital v. Division of Medical Assistance, North Carolina Department of Health and Human Services (02 DHR 1499).