10- 144 C.M.R. ch. 272, § V-F
For those families or providers who verbally or in writing raise concerns or questions regarding denials for payment of discrete bills or services for a C.C.S./C.S.H.N. Program eligible child and do not wish to file a formal appeal, the C.C.S./C.S.H.N. Program Director or his or her designee will review the issue and the child's medical record. The family or provider will be notified in writing of the findings of this review.
If the family or provider is dissatisfied with the decision , the family or provider may request a meeting with the Director of the Division of Maternal and Child Health or his/her designee. This meeting will usually be held at the Department of Human Services, Bureau of Health office in Augusta. However, the family or provider may request a review of the child's written record and payment denial in lieu of a face to face meeting. The decision of the Division Director or his/her designee is final and ends the internal reconsideration process. The family will receive written notification of this decision. The family or provider may appeal any such final decision pursuant to Maine Rule of Civil Procedure Rule 80C and 5 M. R.S.A.11001 et seq.
10- 144 C.M.R. ch. 272, § V-F