(a) Not later than
30 days after a written determination under
7
AAC 150.210(a) is mailed or
electronically delivered to a facility, a facility aggrieved by that
determination may request reconsideration under
7
AAC 150.210(b) or may file a written
notice of appeal with the commissioner. In the notice of appeal, the facility
must
(1) set out a statement of
issues;
(2) identify the basis for
the facility's contention that the written determination of the prospective
payment rate is incorrect;
(3)
specify the relief requested;
(4)
provide a name, address, telephone number, and other contact information for
the facility representative designated as the point of contact for the appeal;
and
(5) include a certificate
showing the date the appeal was mailed or electronically
delivered.
(b) If a
request for reconsideration under
7
AAC 150.210(b) is denied, or if a
facility is aggrieved by a decision on reconsideration under
7
AAC 150.210(b), the facility may file
a written notice of appeal with the commissioner not later than 30 days after
the date the denial or decision is mailed or electronically delivered. In the
notice of appeal, the facility must
(1) set
out a statement of issues;
(2)
identify the basis for the facility's contention that the written determination
of the prospective payment rate is incorrect;
(3) specify the relief requested;
(4) provide a name, address, telephone
number, and other contact information for the facility representative
designated as the point of contact for the appeal; and
(5) include a certificate showing the date
the appeal was mailed or electronically delivered.
(c) If a decision on a prospective payment
rate is appealed to the commissioner, that rate will be effective subject to
adjustment based on the commissioner's decision on the administrative
appeal.
(d) A notice of appeal
under (a) or (b) of this section must be filed at the office of the
commissioner in Juneau, and a copy must be sent to the Anchorage office of the
department with the staff that oversees Medicaid payment rates.
(e) The commissioner will deny an
administrative appeal as untimely if not filed within the time limits set out
in this section.
