Haw. Code R. § 17-1736-58 - Hospital and institutional provider's right to review
(a)
A provider may request an administrative hearing if it is dissatisfied with the
department's determination of medicaid reimbursement:
(1) Following any request for rate
reconsideration determination under PPS; or
(2) Following the issuance of an NPR under
cost reimbursement; and
(3) The
amount in dispute is at least $1,000.
(b) A written request for administrative
hearing must be received by the department within ninety days from the date of
the rate reconsideration determination or NPR as provided in subsection (a) and
shall refer to that specific notification.
(c) The provider's request for an
administrative hearing shall include the following:
(1) Individual adjustment items and the
specific reimbursement issue and the dollar amount entailed;
(2) The reasons for the
disagreement;
(3) Any material or
evidence the provider considers necessary to support its position;
and
(4) The notice with which the
provider disagrees.
(d)
A group of providers may request an administrative hearing if the issue
involves a common question of fact or interpretation, and the amount in
controversy is in the aggregate of $50,000 or more.
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