Or. Admin. Code § 333-004-3210

Current through Register Vol. 64, No. 1, January 1, 2025

Section 333-004-3210 - Agency Requests for Reconsideration

(1) An agency may request reconsideration of a RH Program decision that directly adversely affects the agency such as:

(a) A denial or limitation of payment allowed for services or items provided.

(b) A RH Program overpayment determination made under OAR 333-004-3180 (Recovery of RH Access Fund Overpayments to Agencies Resulting from Review or Audit).

(c) A sanction other than termination.

(2) An agency may request reconsideration by filing a written request with the RH Program within 30 calendar days of the date the RH Program's decision was mailed. A request for reconsideration must:

(a) Provide a clear written expression from an agency identifying the RH decision that is at issue.

(b) Explain the specific reason or reasons the agency disagrees with that decision along with supporting documentation if applicable.

(c) Be received by the RH Program within 30 calendar days of the date the RH Program's decision was mailed in order to be considered timely.

(3) If an agency's request for appeal is not timely, the agency may accept the late request only if the cause for failure to timely request the hearing was beyond the reasonable control of the agency. The RH Program may require the request to be supported by a written statement that explains why the request for review is late.

(4) A request for reconsideration will be reviewed by the Center administrator or designee. The Administrator or designee may issue a decision on reconsideration based on the information submitted by the agency or may request a meeting between the agency and RH Program staff. If a meeting is requested the Center administrator or designee shall notify the agency of the date, time, and place the meeting is scheduled. The meeting may be in person, by phone, or by video conference.

(a) The review meeting shall be conducted in the following manner:

(A) It shall be conducted by the Center administrator or designee;

(B) No minutes or transcript of the review will be made by the Authority;

(C) The agency requesting the review need not be represented by counsel and shall be given ample opportunity to present relevant information;

(D) RH Program staff may attend and participate in the review meeting but only the Center administrator or designees may ask the RH Program staff questions;

(b) An agency's failure to appear without good cause constitutes acceptance of the RH Program's determination;

(c) The Center administrator may combine similar administrative review proceedings, including the meeting, if the Center administrator determines that joint proceedings may facilitate the review; and

(d) The Center administrator or designee may request the agency requesting reconsideration to submit, in writing, new information that has been presented orally. In such an instance, a specific date for receiving such information shall be established.

(5) The decision on the request for reconsideration shall be sent to the agency in writing, explaining the basis for the decision.

(6) The RH Program's decision on a request for reconsideration is final and is an order in other than a contested case under ORS 183.484.

(7) The burden of presenting evidence to support a request for reconsideration is on the agency.

Or. Admin. Code § 333-004-3210

PH 84-2020, adopt filed 12/18/2020, effective 1/1/2021; PH 195-2022, minor correction filed 09/07/2022, effective 9/7/2022; PH 97-2024, minor correction filed 11/26/2024, effective 11/26/2024

Statutory/Other Authority: ORS 413.042, ORS 414.432, ORS 431.147, ORS 431.149, ORS 435.205 & ORS 435.230

Statutes/Other Implemented: ORS 414.432, ORS 431.147, ORS 413.032, ORS 435.205 & ORS 435.230