§ 4-21.5-3-7 — Review; petition; denial of petition; preliminary hearing

Indiana § 4-21.5-3-7

• Jurisdiction: Indiana
• Art. 21.5: ADMINISTRATIVE ORDERS AND
• Ch. 3: Adjudicative Proceedings

Text

(a) To qualify for review of a personnel action
to which IC 4-15-2.2 applies, a person must comply with IC 4-15-2.2-42. To qualify for review of any other order described in
section 4, 5, or 6 of this chapter, a person must petition for review in a
writing that does the following:
(1) States facts demonstrating that:
(A) the petitioner is a person to whom the order is specifically
directed;
(B) the petitioner is aggrieved or adversely affected by the
order; or
(C) the petitioner is entitled to review under any law.
(2) Includes, with respect to determinations of notice of program
reimbursement and audit findings described in section 6(a)(3) and
6(a)(4) of this chapter, a statement of issues that includes:
(A) the specific findings, action, or determination of the office
of Medicaid policy and planning or of a contractor of the office
of Medicaid policy and planning from which the provider is
appealing;
(B) the reason the provider believes that the finding, action, or
determination of the office of Medicaid policy and planning or
of a contractor of the office of Medicaid policy and planning
was in error; and
(C) with respect to each finding, action, or determination of the
office of Medicaid policy and planning or of a contractor of the
office of Medicaid policy and planning, the statutes or rules that
support the provider's contentions of error.
Not more than thirty (30) days after filing a petition for review
under this section, and upon a finding of good cause by the
administrative law judge, a person may amend the statement of
issues contained in a petition for review to add one (1) or more
additional issues.
(3) Is filed:
(A) with respect to an order described in section 4, 5, 6(a)(1),
6(a)(2), or 6(a)(5) of this chapter, with the ultimate authority for
the agency issuing the order within fifteen (15) days after the
person is given notice of the order or any longer period set by
statute; or
(B) with respect to a determination described in section 6(a)(3)
or 6(a)(4) of this chapter, with the office of Medicaid policy and
planning not more than one hundred eighty (180) days after the
hospital is provided notice of the determination.
The issuance of an amended notice of program reimbursement by
the office of Medicaid policy and planning does not extend the
time within which a hospital must file a petition for review from
the original notice of program reimbursement under clause (B),
except for matters that are the subject of the amended notice of
program reimbursement.
If the petition for review is denied, the petition shall be treated as a
petition for intervention in any review initiated under subsection (d).
(b) If an agency denies a petition for review under subsection (a)
and the petitioner is not allowed to intervene as a party in a proceeding
resulting from the grant of the petition for review of another person, the
agency shall serve a written notice on the petitioner that includes the
following:
(1) A statement that the petition for review is denied.
(2) A brief explanation of the available procedures and the time
limit for seeking administrative review of the denial under
subsection (c).
(c) An agency shall assign an administrative law judge, or after June
30, 2020, if the proceeding is subject to the jurisdiction of the office of
administrative law proceedings, an agency shall request assignment of
an administrative law judge by the office of administrative law
proceedings, to conduct a preliminary hearing on the issue of whether
a person is qualified under subsection (a) to obtain review of an order
when a person requests reconsideration of the denial of review in a
writing that:
(1) states facts demonstrating that the person filed a petition for
review of an order described in section 4, 5, or 6 of this chapter;
(2) states facts demonstrating that the person was denied review
without an evidentiary hearing; and
(3) is filed with the ultimate authority for the agency denying the
review within fifteen (15) days after the notice required by
subsection (b) was served on the petitioner.
Notice of the preliminary hearing shall be given to the parties, each
person who has a pending petition for intervention in the proceeding,
and any other person described by section 5(d) of this chapter. The
resulting order must be served on the persons to whom notice of the
preliminary hearing must be given and include a statement of the facts
and law on which it is based.
(d) If a petition for review is granted, the petitioner becomes a party
to the proceeding and:
(1) the agency shall assign the matter to an administrative law
judge or, after June 30, 2020, if the proceeding is subject to the
jurisdiction of the office of administrative law proceedings,
request assignment of an administrative law judge by the office of
administrative law proceedings; or
(2) certify the matter to another agency for the assignment of an
administrative law judge (if a statute transfers responsibility for
a hearing on the matter to another agency).
The agency granting the administrative review or the agency to which
the matter is transferred may conduct informal proceedings to settle the
matter to the extent allowed by law.

Legislative History

As added by P.L.18-1986, SEC.1. Amended by P.L.35-1987, SEC.6; P.L.42-1995, SEC.3; P.L.2-1997, SEC.11; P.L.222-2005, SEC.22; P.L.213-2007, SEC.1; P.L.217-2007, SEC.1; P.L.6-2012, SEC.18; P.L.205-2019, SEC.7.