048-3 Wyo. Code R. § 3-14

Current through April 27, 2019
Section 3-14 - Reconsideration

(a) Request for reconsideration. A provider or the provider's legally authorized representative may request that the Division reconsider a decision to recover excess payments. Such request must be mailed to the Division by certified mail, return receipt requested within twenty days of the date the facility receives notice pursuant to Section 12 or 13. The request must state with specificity the reasons for the request. Failure to provide such a statement shall result in the dismissal of the request with prejudice.

(b) Reconsideration. The Division shall review the decision to recover and send written notice by certified mail, return receipt requested, to the provider of its final decision within forty-five days after receipt of the request for reconsideration or the receipt of any additional information requested pursuant to (c), whichever is later.

(c) Request for additional information. The Division may request additional information from the provider as part of the reconsideration process. Such a request shall be made in writing by certified mail, return receipt requested. The provider must provide the requested information within thirty days after the date of the request. Failure to provide the requested information shall result in the dismissal of the request with prejudice.

(d) Reconsideration shall be limited to whether the Division has complied with the provisions of this Chapter and/or other applicable rules of the Department.

(e) Informal resolution. The provider or the provider's legally authorized representative or the Division may request an informal meeting before the final decision on reconsideration to determine whether the matter may be resolved. The substance of the discussions and/or settlement offers made pursuant to an attempt at informal resolution shall not be admissible as part of a subsequent administrative hearing or judicial proceeding.

(f) Administrative hearing. A provider or the provider's legally authorized representative may request an administrative hearing regarding the final decision pursuant to Chapter 1 by mailing by certified mail, return receipt requested or personally delivering a request for hearing to the Division within twenty days of the date the provider receives notice of the final decision. The request must state with specificity the reasons for the request and the issues the provider intends to raise. Failure to state the reasons with specificity shall result in the dismissal of the request with prejudice. The failure to identify issues shall preclude them from being raised at the administrative hearing or on judicial review.

(g) Failure to request reconsideration. A provider which fails to request reconsideration pursuant to this section may not subsequently request an administrative hearing pursuant to Chapter 1 regarding the decision to recover excess payments.

(h) Confidentiality of settlement agreements. If the Division and a provider enter into a settlement agreement as part of a reconsideration or an administrative hearing, such agreement shall be confidential, except as otherwise provided by law. A breach of confidentiality by the provider shall, at the Divisions option, result in the settlement agreement becoming null and void.

048-3 Wyo. Code R. § 3-14