Or. Admin. Code § 309-015-0055 - Appeals

(1) Rate appeals. A letter will be sent notifying the provider of the interim per diem rate, the year-end settlement rate, or the final settlement rate. A provider shall notify the Division in writing within 15 days of receipt of the letter if the provider wishes to appeal the rate. Letters of appeal must be postmarked within the 15-day limit and addressed to the Assistant Administrator, Administrative Services (the Medicaid Intermediary).

(2) The Medicaid Intermediary will forward all rate appeals to the Manager of the Division's Audit Section for initial consideration. If no resolution is forthcoming, the provider will be given an opportunity for administrative review or a contested case hearing as outlined in OAR 410-120-1400 through 410-120-1600, except that final orders shall be issued by the Administrator of the Division.

(3) Monetary recovery, sanctions, or other appeals. A provider may appeal the Division's proposed action by letter within the same 15-day period as allowed for rate appeals above; address the letter to the Assistant Administrator, Administrative Services (the Medicaid Intermediary).

Notes

Or. Admin. Code § 309-015-0055

MHD 17-1983(Temp), f. 9-30-83, ef. 10-1-83; MHD 21-1983, f. & ef. 12-5-83; MHD 7-1987, f. & ef. 12-30-87; MHD 6-1989, f. & cert. ef. 11-17-89; MHD 12-1990, f. & cert. ef. 10-15-90; MHD 2-1994, f. & cert. ef. 2-24-94

Stat. Auth.: ORS 413.042

Stats. Implemented: ORS 414.025 & 414.065