Kan. Admin. Regs. § 129-9-20

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

Section 129-9-20 - Dismissal; limitations

(a) Any state fair hearing may be considered for dismissal before the state fair hearing is convened. The party seeking to dismiss the state fair hearing shall use a written motion to dismiss the state fair hearing. Written motions to dismiss may be submitted in lieu of the department's summary when based on one of the reasons specified in this subsection. Each written motion to dismiss the state fair hearing shall state one of the following reasons and provide evidence, argument, and citations to federal or state law, regulation, policy, or manual that support the reason for dismissal:

(1) The appellant failed to submit a request for a state fair hearing within the timeliness standards specified in 129-9-11.

(2) The appellant failed to submit a request for an appeal of the adverse benefit determination or action to the MCE in accordance with 129-9-7 before submitting a request for a state fair hearing.

(3) The appellant failed to state a claim.

(4) The department or the MCE has not taken an action or made a benefit determination adverse to the appellant.

(5) The department or MCE reversed its action or adverse benefit determination.

(6) The request for a state fair hearing was submitted by an individual or entity without documentation of authorization from the appellant.

(7) The appellant challenges the validity of or states a disagreement with federal or state law, regulation, or policy. The department shall not submit a written motion to dismiss for a state fair hearing request in which the appellant is challenging an incorrect computation or determination by the department or the MCE using the law, regulation, or policy.

(8) The department or the MCE has taken an action required by federal or state law or regulation, including an automatic or mandated adjustment that is applied to a class of enrollees or providers that included the appellant. The department shall not submit a written motion to dismiss for a state fair hearing request in which the appellant is challenging an incorrect computation or determination by the department or the MCE using the law, regulation, or policy.

(9) The secretary or the department has taken an action required by the governor of the state of Kansas that is applied to a class of providers that included the appellant.

(b) Any written motion to dismiss may be filed with the presiding officer by the department or the department's designee who has been delegated authority to file the motion.

(c) If the motion to dismiss is denied, the presiding officer shall file notification of the denial.

(d) If the department or the MCE seeks to dismiss a state fair hearing on the basis that the action or adverse benefit determination being appealed is based on federal or state law, regulations, or policy, including an action or adverse benefit determination based upon changes in federal or state law, regulations, or policy, and the action or adverse benefit determination made by the department or the MCE shall result in the termination, suspension, or reduction of covered services, the covered services shall continue until a decision concerning the request for dismissal is rendered.

Kan. Admin. Regs. § 129-9-20

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