Kan. Admin. Regs. § 129-9-20 - Dismissal; limitations
(a) Any
state fair hearing may be considered for dismissal before the state fair
hearing is convened. The party seeking to dismiss the state fair hearing shall
use a written motion to dismiss the state fair hearing. Written motions to
dismiss may be submitted in lieu of the department's summary when based on one
of the reasons specified in this subsection. Each written motion to dismiss the
state fair hearing shall state one of the following reasons and provide
evidence, argument, and citations to federal or state law, regulation, policy,
or manual that support the reason for dismissal:
(1) The appellant failed to submit a request
for a state fair hearing within the timeliness standards specified in
129-9-11.
(2) The appellant failed
to submit a request for an appeal of the adverse benefit determination or
action to the MCE in accordance with 129-9-7 before submitting a request for a
state fair hearing.
(3) The
appellant failed to state a claim.
(4) The department or the MCE has not taken
an action or made a benefit determination adverse to the appellant.
(5) The department or MCE reversed its action
or adverse benefit determination.
(6) The request for a state fair hearing was
submitted by an individual or entity without documentation of authorization
from the appellant.
(7) The
appellant challenges the validity of or states a disagreement with federal or
state law, regulation, or policy. The department shall not submit a written
motion to dismiss for a state fair hearing request in which the appellant is
challenging an incorrect computation or determination by the department or the
MCE using the law, regulation, or policy.
(8) The department or the MCE has taken an
action required by federal or state law or regulation, including an automatic
or mandated adjustment that is applied to a class of enrollees or providers
that included the appellant. The department shall not submit a written motion
to dismiss for a state fair hearing request in which the appellant is
challenging an incorrect computation or determination by the department or the
MCE using the law, regulation, or policy.
(9) The secretary or the department has taken
an action required by the governor of the state of Kansas that is applied to a
class of providers that included the appellant.
(b) Any written motion to dismiss may be
filed with the presiding officer by the department or the department's designee
who has been delegated authority to file the motion.
(c) If the motion to dismiss is denied, the
presiding officer shall file notification of the denial.
(d) If the department or the MCE seeks to
dismiss a state fair hearing on the basis that the action or adverse benefit
determination being appealed is based on federal or state law, regulations, or
policy, including an action or adverse benefit determination based upon changes
in federal or state law, regulations, or policy, and the action or adverse
benefit determination made by the department or the MCE shall result in the
termination, suspension, or reduction of covered services, the covered services
shall continue until a decision concerning the request for dismissal is
rendered.
Notes
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