Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 01 - PROCEDURES
Chapter 10.01.09 - Procedures for Hearing Before the Hospital Appeal Board and Nursing Home Appeal Board
Section 10.01.09.03 - Notice of Appeal

Universal Citation: MD Code Reg 10.01.09.03

Current through Register Vol. 51, No. 19, September 20, 2024

A. An opportunity for a hearing shall be provided to any hospital or nursing home that requests review of a final cost settlement by filing a written notice of appeals with the Board not later than 30 days after receipt of the notice of final cost settlement. This notice shall be filed in a format prescribed by the Board.

B. The notice of appeal shall be delivered in person to the Board at the address designated by the notice of final cost settlement or shall be sent by registered or certified mail, return receipt requested.

C. The notice of appeal shall describe with specificity the particular cost adjustments appealed by the provider as well as the fiscal years in which those adjustments have been applied.

D. The provider may elect one of the following types of procedures:

(1) The consideration by the Board solely of written material submitted by the provider and the Medical Assistance Program, or its designee, and upon which the Board shall render a decision. The Board may establish time limits within which the material is to be submitted.

(2) The consideration by the Board of written material submitted by the provider and the Medical Assistance Program, or its designee, and brief, informal oral arguments. Each party may submit oral arguments by not more than two persons. Formal testimony, swearing in, or witnesses or recording of proceedings may not take place. The Board shall render a decision based upon the written materials submitted and the oral arguments presented.

(3) A full evidentiary hearing, including a prehearing conference, in accordance with Regulations .04, .05, and .06 of this chapter.

E. The procedures provided in §D(3) of this regulation will be followed if the Medical Assistance Program objects in writing to the election of a procedure provided for in §D(1) or (2) of this regulation within 10 working days of receipt of the election.

F. The Board shall prescribe the format in which the provider may elect the type of procedure desired with the submission of an appeal. This election shall be binding and constitutes a waiver of any other form of hearing before the Board for that particular appeal unless the Medical Assistance Program objects in the manner provided in §E of this regulation.

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