New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 503 - Adjudicatory Proceedings
Section 503.8 - Hearing procedures: denial of request for rate revision

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 503.8

Current through Register Vol. 46, No. 39, September 25, 2024

(a) This section shall apply to hearings held pursuant to any law or regulation giving a facility licensed by the Office of Mental Health the right to request a hearing to appeal a determination by the commissioner regarding the facility's request for revision of a certified rate of payment. Where a conflict exists between this section and any other section of this Part, the provisions of this section shall be controlling.

(b) If the commissioner denies some or all of the revisions to the rate requested by a provider, the determination shall be final unless, within 30 days of service of the notification of denial, the provider requests a hearing pursuant to this Part. The notification of denial, as served on the provider, shall be deemed to be the notice of proposed action under section 503.4(a) of this Part.

(c) If the commissioner approves the revisions to the rate requested by the provider and the State Division of the Budget denies the revision, the provider shall have no further right to administrative review pursuant to this Part.

(d) A request for a hearing pursuant to this section shall be sent to the commissioner by registered or certified mail and shall contain a statement of the factual issues in dispute.

(e) Upon receipt of a request for a hearing, the commissioner shall determine whether a hearable factual issue is in dispute. If it is determined that there is no factual issue in dispute, the request for a hearing shall be denied; no administrative appeal shall be available from this determination. When it is determined that there is a factual issue in dispute, the commissioner shall order an administrative hearing to be held.

(f) The burden of proof shall be on the provider to prove by clear and convincing evidence that findings of fact on which the determination was based are incorrect.

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