Utah Administrative Code
Topic - Health
Title R410 - Health Care Financing
Rule R410-14 - Administrative Hearing Procedures
Section R410-14-8 - Prehearing Procedures
Current through Bulletin 2024-06, March 15, 2024
(1) DIH shall schedule a preliminary conference, or begin negotiations in writing, within 30 calendar days from the date it receives the request for a hearing or agency action.
(2) The hearing officer may elect to conduct a preliminary conference to:
(3) The hearing officer may request a review of the medical record by a DIH CHEC Utilization Review committee to evaluate the medical necessity of benefits or services under dispute. The committee's recommendation is not binding, but may be admitted as evidence and included in the hearing record. If a party to the proceeding objects to the committee's determination, a representative of the committee must be available at the hearing for examination by the hearing officer and the parties.
(4) The hearing officer may require the parties to submit a prehearing position statement setting forth the parties' positions.
(5) The parties may enter into a written stipulation during the preliminary conference or at any time during the process.
(6) Ex parte communications with the hearing officer are prohibited. If a party attempts ex parte communication, the hearing officer shall inform the offeror that any communication the hearing officer receives off the record, will become part of the record and furnished to all parties. Ex parte communications do not apply to communications on the status of the hearing and uncontested procedural matters.
(7) The agency shall allow the aggrieved person or a representative to examine all DIH documents and records upon written request to DIH at least three days before the hearing.
(8) A party may request access to protected health information in accordance with Rule 380-250, which implements the privacy rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
(9) The hearing officer may require each party to file a signed prehearing disclosure form at least ten calendar days before the scheduled hearing that identifies:
(10) Each party shall supplement the disclosure form with information that becomes available after filing the original form.