Utah Admin. Code R986-700-733 - Administrative Disqualification Hearing (ADH)
(1) An ADH will be held if the Director of
OCC recommends disqualifying a provider pursuant Subsections
R986-700-726(2),
R986-700-730(4),
or R986-700-732(4).
If the provider does not participate in the ADH, the ALJ will make a decision
based solely on the evidence before the ALJ.
(2) The hearing procedures set forth in Rule
R986-100 apply to an ADH unless otherwise specified or inconsistent with this
section.
(3) The Division of
Adjudication will schedule any ADH. Each party will be given 30-days' notice of
the date and time of the ADH.
(a) The
Department may withdraw a request for an ADH at any time before the scheduled
hearing by sending written notice to the Division of Adjudication and any
party.
(4) The Division
of Adjudication may combine a fair hearing and an ADH into a single hearing if
the relevant factual issues arise out of the same or related circumstances.
(a) The notice of hearing shall indicate
whether a fair hearing and an ADH will be combined into a single
hearing.
(b) If the hearings are
combined, the applicable filing deadline and hearing timeframe are those
contained in this section to the extent of any conflict.
(c) If the provider fails to appear or
participate in the combined hearing, the fair hearing will be dismissed but the
ADH will still be held.
(5) The ALJ shall advise a witness that the
witness has the right to refuse to answer any question during the hearing, and
that the ALJ may draw any reasonable adverse inference based on a party's
refusal to answer a question during the hearing.
(6) A qualified employee of the Department
shall represent the Department at the ADH.
(7) If any party fails to participate in the
hearing and disagrees with the hearing decision, the party may request
reopening of the hearing as set forth in Section
R986-100-131.
(8) Within 90 days of the date the notice of
hearing is issued, the ALJ shall conduct the hearing, arrive at a decision, and
issue written notice of the decision to the Department and each party. If the
ADH is postponed for any reason, the 90-day time limit will be extended by as
many days as the ADH is postponed.
(a) The ALJ
shall determine if the provider should be disqualified pursuant to Section
R986-700-734.
(9) The ALJ is not required to
disqualify a provider based solely upon a finding of IPV. If the ALJ determines
the provider's conduct does not warrant disqualification, the Department may
establish an overpayment pursuant to Section
R986-700-731, assess a penalty
pursuant to Section R986-700-732, and take remedial
action pursuant to Subsection
R986-700-727(6).
(10) Any party, including the Department, may
request a further appeal pursuant to Section
63G-4-402 of the Administrative
Procedures Act, Section
R986-100-135, and Subsection
R986-100-735(3).
Notes
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