Kan. Admin. Regs. § 129-7-13

Current through Register Vol. 44, No. 2, January 9, 2025

Section 129-7-13 - Parties

(a) The parties to each state fair hearing shall be an appellant and a respondent. The case caption in each medical assistance state fair hearing case shall identify the appellant and the respondent as follows:

(1) The named appellant in the case caption shall be an applicant or beneficiary. Any authorized representative of the applicant or beneficiary may request a state fair hearing.

(A) A state fair hearing may be requested only by or on behalf of the appellant applying for or receiving covered services and benefits.

(B) Any appellant applying for or receiving covered services and benefits may designate, in writing, an individual or entity to request a state fair hearing and represent the appellant in a state fair hearing. The appellant shall be the only individual who can grant another individual or entity the authorization to request a state fair hearing and represent the appellant in a state fair hearing subject to the exception in paragraph (a)(1)(C).

(C) The individual or entity authorized to request a state fair hearing and represent the appellant in a state fair hearing shall not transfer written authorization to another individual or entity unless the authorized individual or entity has a power of attorney or is a guardian or conservator appointed by a court of competent jurisdiction. Any power of attorney, guardian, or conservator may authorize an individual or entity, in writing, to request a state fair hearing and represent the appellant in a state fair hearing.

(D) Written authorization, including power of attorney, letters of guardianship, or letters of conservatorship, shall accompany all state fair hearing requests made on an appellant's behalf, with the following exceptions:

(i) An unemancipated minor appellant's parent or legal guardian may request a state fair hearing on behalf of the appellant and represent the appellant in a state fair hearing without written authorization.

(ii) Any attorney-at-law retained by the appellant or the appellant's representative may request a state fair hearing on behalf of the appellant using the attorney's official letterhead or other proof of representation as written authorization.

(2) The named respondent in the case caption shall be the department, nursing facility, or skilled nursing facility taking the action.

(A) If the matter involves an action regarding eligibility, the respondent shall be the department that took the action. If the eligibility determination process requires several agencies to act consecutively, the respondent shall be the department that took the action involving the portion of the eligibility process that is being appealed in the state fair hearing.

(B) If the matter involves the termination, suspension, or reduction of previously authorized and ongoing FFS covered services, the respondent shall be the secretary.

(C) If the matter involves determinations concerning the preadmission screening and annual resident review, the respondent shall be the department designated as responsible for these determinations.

(D) The department shall review the matters identified in paragraphs (a)(2)(A) through (a)(2)(C) to determine whether both of the following conditions are met:

(i) The matter was filed within the regulatory time frame.

(ii) The matter involves an action.

(E) If the department determines that the matter has not satisfied each of the conditions specified in paragraph (a)(2)(D), the department shall submit a request to the presiding officer to dismiss the matter.

(F) If the matter involves the transfer or discharge of a medicaid or non-medicaid resident in a nursing facility or skilled nursing facility, the respondent shall be the nursing facility or skilled nursing facility that made the transfer or discharge decision. A designation of legal counsel for the respondent shall not affect the identification of the respondent as named party in the case caption.

(b) The presiding officer conducting the state fair hearing may grant a motion to modify the case caption to clarify the parties.

(c) Any applicant or beneficiary may authorize representation by legal counsel, a relative, a friend, or a spokesperson in the state fair hearing if the applicant or beneficiary has authorized the representation in writing. This regulation shall not authorize the secretary or the presiding officer to grant exceptions to the Kansas supreme court rules concerning the practice of law in Kansas if the applicant or beneficiary is represented by an attorney who is not licensed in Kansas.

(d) If the applicant for or beneficiary of medical assistance has died before filing a request for a state fair hearing, then an administrator or executor appointed by a court in the estate proceedings of the deceased applicant or beneficiary may file the request for a state fair hearing. The appellant shall be the estate of the deceased applicant or beneficiary.

(e) If the applicant for or beneficiary of medical assistance has died after filing a request for a state fair hearing, then an administrator or executor appointed by a court in the estate proceedings of the deceased applicant or beneficiary may request to substitute the estate of the deceased applicant or beneficiary as the appellant.

(f) If a presiding officer allows an entity to intervene in a state fair hearing covered by this article of the division's regulations pursuant to KAPA, the intervening entity shall be identified in the caption of the case as an intervenor.

Kan. Admin. Regs. § 129-7-13

Authorized by and implementing K.S.A. 651,254 and 75-7403; adopted by Kansas Register Volume 43, No. 50; effective 12/27/2024.