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