Michigan Administrative Code
Department - Health and Human Services
Medical Services Administration
MSA Provider Hearings
Section R. 400.3405 - Internal Conference

Universal Citation: MI Admin Code R. 400.3405

Current through Vol. 24-04, March 15, 2024

Rule 5.

(1) Before a provider or an applicant requests an administrative hearing, a provider or an applicant may request an internal conference. The purpose of the internal conference is to determine whether the department action was taken according to policy.

(2) The provider or applicant may meet with a department staff member who acts as the appeals review officer from the appeals section or its successor section. The staff member is an impartial arbiter who facilitates the communication and the exchange of information between the provider or applicant and the department program staff.

(3) All requests for an internal conference must be submitted in writing to the department. The appeals review officer may deny requests for internal conferences received after 30 days or after the date specified in the notice of adverse action.

(4) A request must state all of the following:

(a) Item or items being appealed.

(b) The dollar amount involved, if any.

(c) All necessary documentation to support the reason for the internal conference.

(d) Failure to follow the requirements in this subrule may result in the denial of the internal conference by the appeals review officer.

(5) The appeals section must issue a decision within 30 days after the conclusion of the internal conference.

(6) Should the provider, applicant, and/or the department disagree with the internal conference decision, the provider, applicant, and/or the department has the right to an administrative hearing. Requests for an administrative hearing must be in writing and made within 30 days of the decision of the internal conference decision.

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