Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 22 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ADMINISTRATION
Article 11 - CIVIL MONETARY PENALTIES AND ASSESSMENTS
Section R9-22-1111 - Issues and Burden of Proof
Universal Citation: AZ Admin Code R 9-22-1111
Current through Register Vol. 30, No. 52, December 27, 2024
A. Preponderance of evidence. In any State Fair Hearing conducted under R9-22-1110, AHCCCS shall prove by a preponderance of the evidence that a person presented or caused to be presented each claim in violation of this Article and any aggravating circumstances under R9-22-1105. A person shall bear the burden of producing and proving by a preponderance of the evidence any circumstance that would justify reducing the amount of the penalty, assessment, or penalty and assessment.
B. Statistical sampling.
1. In meeting the burden of proof
described in subsection (A), AHCCCS may introduce the results of a statistical
sampling study as evidence of the number and amount of claims that were
presented or caused to be presented by the person. A statistical sampling study
constitutes prima facie evidence of the number and amount of claims if computed
by valid statistical methods.
2.
The burden of proof shall shift to the person to produce evidence reasonably
calculated to rebut the findings of the statistical sampling study once AHCCCS
has made a prima facie case as described in subsection (B)(1). AHCCCS shall be
given the opportunity to rebut this evidence.
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