Current through Register Vol. 50, No. 9, September 20, 2024
A. When
DHH imposes a sanction on a health care provider, it will give the provider
written notice of the imposition. The notice will be given by certified mail
and will include the following:
1. the nature
of the violation(s) and whether the violation(s) is classified as a repeat
violation;
2. the legal authority
that established the violation(s);
3. the civil fine assessed for each
violation;
4. inform the
administrator of the facility that the facility has 10 days from receipt of the
notice within which to request an informal reconsideration of proposed
sanction;
5. inform the
administrator of the facility that the facility has 30 days from receipt of the
notice within which to request an administrative appeal of the proposed
sanction and that the request for an informal reconsideration does not extend
the time limit for requesting an administrative appeal; and
6. inform the administrator of the facility
that the consequences of failing to request an informal reconsideration and/or
an administrative appeal will be that DHH's decision is final and that no
further administrative or judicial review may be had.
B. The provider may request an informal
reconsideration of DHH's decision to impose a civil fine. This request must be
written and made to DHH within 10 days of receipt of the notice of the
imposition of the fine.
1. This
reconsideration will be conducted by designated employees of DHH who did not
participate in the initial decision to recommend imposition of a
sanction.
2. Oral presentation can
be requested by the provider representative, and if requested, will be made to
the designated employees.
3.
Reconsideration will be made on the basis of documents and oral presentations
made by the provider to the designated employees at the time of the
reconsideration.
4. Correction of
the deficient practice for which the sanction was imposed will not be the basis
of the reconsideration.
5. The
designated employees will only have the authority to confirm, reduce or rescind
the civil fine.
6. DHH will notify
the provider of the results of the reconsideration within 10 working days after
the oral presentation.
7. This
process is not in lieu of the administrative appeal and does not extend the
time limits for filing an administrative appeal.
C. The facility may request an administrative
appeal. If an administrative appeal is requested in a timely manner, the appeal
will be held as provided in the Administrative Procedure Act (R.S.
49:950 et seq.) An appeal bond will be posted
with the Bureau of Appeals as provided in
R.S.
40:2199(D) or the provider
may choose to file a devolutive appeal. A devolutive appeal means that the
civil fine must be paid in full within 10 days of filing the appeal.
D. The provider may request judicial review
of the administrative appeal decision as provided in the Administrative
Procedure Act.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
