Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 45 - RATES FOR NURSING FACILITY SERVICES
Section 471-45-014 - ADMINISTRATIVE FINALITY

Administrative decision or inaction in the allowable cost determination process for any provider, which is otherwise final, may be reopened by the Department within three years of the date of notice of the decision or inaction. Reopening means an action taken by the Division Director to reexamine or question the correctness of a determination or decision which is otherwise final. The Division Director is the sole authority in deciding whether to reopen. The action may be taken on the initiative of the Department within the three-year period; in response to a written request from a provider or other entity within the three-year period. Whether the Division Director will reopen a determination, which is otherwise final, depends on whether new and material evidence has been submitted, a clear and obvious error has been made, or the determination is found to be inconsistent with the law, regulations and rulings, or general instructions; or anytime fraud or abuse is suspected. A provider does not have the right to appeal a finding by the Division Director that a reopening or correction of a determination or decision is not warranted.