Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-70 - Hearing or Review for Providers
Section 5160-70-03 - Chapter 119. hearings: department notice, making a hearing request, and failure to make a hearing request
Universal Citation: OH Admin Code 5160-70-03
Current through all regulations passed and filed through September 16, 2024
(A) Notice of intended action
(1)
Whenever ODM proposes to take an action that the Ohio
general assembly has expressly made subject to the administrative adjudication
procedure outlined in Chapter 119. of the Revised Code, ODM shall give notice
of the intended action to the party informing the party of the party's right to
a hearing. Notice shall be given by certified mail, return receipt requested,
and shall, at a minimum, include all of the following:
(a)
The specific
action or actions ODM intends to take;
(b)
The charges or
other reasons for the proposed action or actions;
(c)
The statutes or
rules directly involved;
(d)
A statement informing the party that the party is
entitled to a hearing if the party requests it within thirty calendar days of
the time of mailing the notice;
(e)
A statement
informing the party that at the hearing the party may appear in person or
through an attorney;
(f)
A statement informing the party that the party or the
party's attorney may present the party's position, arguments or contentions
entirely in writing, and that at the hearing the party or the party's attorney
may present evidence and examine witnesses appearing for and against the party;
and
(g)
A statement informing the party that rules governing
hearings in accordance with Chapter 119. of the Revised Code are found in
Chapter 5160-70 of the Administrative Code.
(2)
ODM shall also
mail a copy of the notice to the party's attorney or other representative of
record. To qualify as an attorney or representative of record, the party or the
attorney or representative shall notify ODM, in writing, that the attorney or
representative is to be designated the attorney or representative of record.
The notification shall include the address where ODM should mail the notice to
the attorney or representative of record. The mailing of notice to the party's
attorney or representative is not deemed to perfect service of the notice.
Failure to mail a copy of the notice to the attorney or representative of
record shall not result in failure of otherwise perfected service upon the
party. In those instances where a party is a corporation doing business in Ohio
or is incorporated in Ohio, the mailing of notice to the corporation's
statutory agent pursuant to sections
1701.07 and
1703.19 of the Revised Code
shall perfect service, provided that all the requirements of paragraph (A) of
this rule are met.
(3)
When any notice sent by certified mail pursuant to
this rule is returned because the party fails to claim the notice, ODM shall
send the notice by ordinary mail to the party at the party's last known address
and shall obtain a certificate of mailing. Service by ordinary mail is complete
when the certificate of mailing is obtained unless the notice is returned
showing failure of delivery.
(4)
If any notice
sent by certified or ordinary mail is returned for failure of delivery, ODM
either shall make personal delivery of the notice by an employee or agent of
ODM or shall cause a summary of the substantive provisions of the notice to be
published once a week for three consecutive weeks in a newspaper of general
circulation in the county where the last known address of the party is located.
When notice is given by publication, a proof-of-publication affidavit, with the
first publication of the notice set forth in the affidavit, shall be mailed by
ordinary mail to the party at the party's last known address and the notice
shall be deemed received as of the date of the last publication. An employee or
agent of ODM may make personal delivery of the notice upon a party at any
time.
(5)
Refusal of delivery by personal service or by mail is
not failure of delivery, and service is deemed to be complete at the time of
personal refusal or at the time of receipt by ODM of the refused mail as
demonstrated by the ODM time and date stamp. Failure of delivery occurs only
when a mailed notice is returned by the postal authority marked undeliverable,
address or addressee unknown, or forwarding address unknown or
expired.
(B) Making a request for a hearing
(1)
Any request for
a hearing made as the result of notice issued pursuant to paragraph (A) of this
rule must be made in writing and mailed or delivered to the depository agent
within thirty calendar days of the following, as applicable:
(a)
The time of
mailing the notice if notice is given pursuant to paragraph (A)(1) of this
rule;
(b)
The date that service is complete if notice is given
pursuant to paragraph (A)(3) or (A)(5) of this rule;
(c)
The date of the
last publication if notice is given by publication pursuant to paragraph (A)(4)
of this rule; or
(d)
The date of personal service.
(2)
If a
request for a hearing is mailed to the depository agent, the request is deemed
to have been made as follows:
(a)
If the request is mailed by certified mail, as of the
date stamped by the U.S. postal service on its receipt form (PS form 3800 or
any future equivalent postal service form);
(b)
If the request
is mailed by ordinary U.S. mail, as of the date of the postmark appearing upon
the envelope containing the request;
(c)
If the request
is mailed by ordinary U.S. mail and the postmark is illegible or fails to
appear on the envelope, as of the date of its receipt by the depository agent
as evidenced by the agent's time stamp.
(3)
If a request for
a hearing is made by facsimile transmission or by electronic mail to the
depository agent, the request is deemed to have been made as of the date of its
receipt as evidenced by the receipt date generated by the facsimile
transmission or the date of receipt shown in the source code of the electronic
mail received by the depository agent.
(4)
If a request for
a hearing is mailed, personally delivered, made by facsimile transmission, or
made by electronic mail to a person or address other than the depository agent,
the request is deemed to have been made as of the date of its receipt by the
depository agent as evidenced by the depository agent's time
stamp.
(5)
If a request for a hearing is personally delivered to
the depository agent, the request is deemed to have been made as of the date of
its receipt as evidenced by the depository agent's time stamp.
(6)
All requests for
hearings must include a copy of the notice of intended action that is being
contested and clearly identify the party who is making the request by providing
the party's name, address, and phone number.
(C) Failure to request a hearing
When a party fails to request a hearing or the request is not submitted timely, ODM shall issue an adjudication order adopting and implementing the notice of intended action.
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.