Kan. Admin. Regs. § 129-7-17

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

Section 129-7-17 - Department's summary

(a) Within 30 days of the date of the acknowledgment and order issued by the presiding officer in response to a request for state fair hearing, the appellant and the presiding officer shall be furnished by the department with a summary providing the following information and exhibits:

(1) The appellant's name and address;

(2) a summary statement concerning why the appellant is filing a request for a state fair hearing;

(3) a brief and relevant chronological summary of the events that occurred in relationship to the appellant's request for a state fair hearing;

(4) a statement of the basis of the adverse action;

(5) a citation to and copy of the applicable policies or manual excerpts relied upon for the decision. The applicable medical necessity criteria or guidelines used in making medical necessity decisions shall be included;

(6) a citation to or copy of the applicable Kansas and federal statutes and regulations relied upon for the adverse action;

(7) a citation to or copy of the applicable state plan or waiver documents relied upon for the adverse action;

(8) a copy of the notice which notified the appellant of the decision in question and any subsequent notices;

(9) a copy of any applicable correspondence; and

(10) the name and title of each person who will testify or represent the secretary at the state fair hearing.

(b) Upon written request by the department, the presiding officer may grant additional time for the completion of the summary. The presiding officer shall file notification of the approval or denial of the extension request. If approved, the notification shall include the revised due date for the department's summary.

(c) The department's summary shall be submitted to the presiding officer and the appellant within 30 days as specified in subsection (a) or by the date approved by the presiding officer as specified in subsection (b), unless there is an administrative or other emergency beyond the control of the presiding officer or the department. The due date for the department's summary may be modified by the presiding officer before or after the administrative or other emergency.

(d) If the responsibility for the preparation of the department's summary has been given to the secretary's designee, the secretary's designee shall meet the requirements of this regulation and any additional directives by the department.

Kan. Admin. Regs. § 129-7-17

Authorized by and implementing K.S.A. 65-1,254 and 75-7403; effective, T-129-1-6-23, Jan. 6, 2023; adopted by Kansas Register Volume 43, No. 50; effective 12/27/2024.