§ 40-8-21 - Appeals process.
SECTION 40-8-21
§ 40-8-21 Appeals process. – (a) Any provider that is not in agreement, after being provided an exit auditconference or rate appeal conference, with a final rate of reimbursementassigned as a result of an audit for its base year, or with the application ofthe principles of reimbursement for an applicable year, may within fifteen (15)days from the date of notification of audit results or rate assignment, file awritten request with the department for a review of the computation of theassigned rate. The foregoing right of appeal shall also apply to demonstratederrors made during the rate determination process.
(b) A review conference will be conducted within fifteen (15)days from the date of receipt of the written request by a designee assigned bythe director of the department of human services. As a result of the reviewconference, the designee may modify the audit adjustments and/or the rate ofreimbursement. The designee shall provide the facility with a written decisionwithin thirty (30) days from the date of the review conference.
(c) Appeals beyond the review conference shall be inaccordance with the provisions of chapter 35 of title 42. The facility shallfile a written request for the hearing no later than fifteen (15) days afterreceipt of the review conference decision.