reglab/statecodes huggingface dataset:
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-3 - SANCTIONS FOR NURSING FACILITIES › Rule 350-3-.06 - Monitoring

Current through Rules and Regulations filed through June 27, 2024
(1) The Department shall maintain procedures and adequate staff
				on-site, on a regular, as-needed basis, to monitor the facility's operations,
				advise the facility in its effort to come into or maintain compliance, to
				report to the licensing agency, and to investigate complaints of violations
				which are not easily verified on one visit.
(a) One or more monitor(s) shall be placed in the nursing
				facility:
1. when it has been found on three (3) standard surveys that
				the nursing facility has provided substandard quality of care;
2. when the facility has been under temporary
				management;
3. to ensure that Class A & B violations have been and
				continue to be corrected; or
4. when the Department has reason to question a nursing
				facility's compliance.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-3 - SANCTIONS FOR NURSING FACILITIES › Rule 350-3-.07 - Notice

Current through Rules and Regulations filed through June 27, 2024
(1) The Department shall give notice of the imposition of any
				remedy described in this Chapter as follows:
(a) To the facility in writing, transmitted in a manner which
				will reasonably ensure timely receipt by the facility.
(b) To the public by transmitting printed Notices to the
				facility. Such Notices shall be at least 11 1/2 inches by 17 1/2 inches in size
				and of sufficient legibility that they may reasonably be expected to be
				readable by the facility's residents or their representatives. A printed notice
				shall not be transmitted or required to be posted for a Plan of
				Correction.
(c) To the State Long-Term Care Ombudsman by placing copies
				with the U. S. Postal Service of all notices to the facility.
(d) To the State Survey Agency in writing.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-3 - SANCTIONS FOR NURSING FACILITIES › Rule 350-3-.08 - Administrative Review

Current through Rules and Regulations filed through June 27, 2024
(1) Should the facility wish to contest imposition of a remedy,
				other than a Plan of Correction and except as provided in Sections .03(e) and
				 .05(c), a written request for Administrative Review must be received by the
				Department within ten (10) days of the facility's receipt of notice of
				imposition of the remedy. The request shall state specifically each remedy
				disputed and, for each disputed remedy, the specific basis of the dispute. For
				imposition of civil monetary penalties, it shall not be a valid basis for
				dispute that a deficiency no longer exists. The timely filing of a request
				shall stay imposition of the remedy pending the Administrative Review decision,
				except where the Department has determined there is immediate jeopardy to the
				health or safety of the residents in a facility, in which case the Department
				may impose the remedies described in Subsections .02(b),(g)or(h), as
				determined appropriate by the Department. If the facility fails to file a
				timely request, the decision to impose a remedy or remedies shall become final
				and no further administrative or judicial review or hearing shall be
				available.
(2) The reviewing official shall be a Department employee
				appointed by the Commissioner and shall have authority only to affirm the
				decision, to revoke the decision, to affirm part and to revoke part, to order
				an immediate survey of the facility, to change the classification of the civil
				monetary penalty (for example, from A to B), or to request additional
				information from the State Survey Agency, the facility, or both, the Long-Term
				Care Ombudsman, or the family or resident council of the facility. Additional
				information that is requested must be supplied within ten (10) business days
				from the date of notice to the party of whom it is requested. Reviewing
				official shall be without authority to compromise the dollar amount of any
				civil monetary penalty within a deficiency class.
(3) The Department shall issue a written decision within ten
				(10) business days of its receipt of the request for Administrative Review. The
				Review shall be made solely on the basis of the State Survey Agency
				recommendation, the survey report, the statement of deficiencies, any
				documentation the facility submits to the Department at the time of its
				Request, and information received as a result of a request made by the
				reviewing official. For the purposes of such Review, a hearing shall not be
				held and oral testimony shall not be taken. Correction of a deficiency or
				deficiencies shall not be a basis for favorable reconsideration of imposition
				of civil monetary penalties.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a).
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-3 - SANCTIONS FOR NURSING FACILITIES › Rule 350-3-.09 - Administrative Hearing

Current through Rules and Regulations filed through June 27, 2024
(1) Should the facility wish to appeal the Administrative
				Review decision for remedies described in Subsections .02(a),(b),(c),(g),and(h), and for Subsection (d) where no determination of immediate jeopardy
				has been made, it may request an administrative hearing. Subsequent correction
				of a deficiency or deficiencies shall not constitute a defense to the
				imposition of a remedy or remedies. The hearing request shall state
				specifically which portion(s) of the Administrative Review decision the
				facility contests. A hearing shall be granted only if Administrative Review was
				timely requested, and a written request for a hearing has been received by the
				State Survey Agency within ten (10) business days of the facility's receipt of
				the Administrative Review decision. Failure to file a timely request shall
				result in the Administrative Review decision becoming final, and no further
				administrative or judicial review or hearing shall be available.
(2) If the Department has imposed temporary management pursuant
				to the provisions of Subsection .05(c), or imposed either of the remedies
				specified in Subsection .02(e), the facility shall be entitled to a hearing
				which shall commence not less than five (5) nor more than ten (10) days after
				the facility's receipt of notice of imposition of said remedy or remedies. No
				Administrative Review shall be conducted in such cases and no request for
				hearing shall be required. The date, time, and location of the hearing shall be
				included in the Notice of imposition of the remedy or remedies. A facility may
				waive its right to a hearing by written notice to the State Survey
				Agency.
(3) Except for appointment of a temporary manager (unless the
				Department has determined that immediate jeopardy to the health or safety of a
				facility's residents exists), termination of a facility's participation,
				closure of a facility, or payment of civil monetary penalties, the imposition
				of remedies shall not be stayed during the pendency of any
				hearing.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a).
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.01 - Hearings Conducted by the Department of Medical Assistance

Current through Rules and Regulations filed through June 27, 2024
(1) An Administrative Law Judge appointed by the Department
				shall conduct provider hearings with respect to the following cases:
(a) when a provider is aggrieved by an action of the Department
				with respect to a denial of, or the determination of the amount of, medical
				assistance paid on a certain item of medical or remedial care or service
				rendered by such provider;
(b) when a provider of medical assistance is aggrieved by an
				action of the Department with respect to the Department's determination of the
				provider's billing rate or reimbursement rate for a particular fiscal
				year;
(c) when a person or institution either has been refused
				enrollment as a provider in the State Plan or has been suspended or terminated
				as a provider by the Department for any reason other than want of any license,
				permit, certificate, approval, registration, charter, or other form of
				permission issued by an entity other than the Department, which form of
				permission is required by law either to render care or to receive medical
				assistance in which federal financial participation is available;
(d) when a provider is aggrieved by any adverse action
				specified in these Rules, except as provided in Chapter 350-3, or a Policies
				and Procedures Manual published by the Department.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.02 - Hearings Conducted by the Department of Human Resources

Current through Rules and Regulations filed through June 27, 2024
(1) Hearings shall be conducted by the Department of Human
				Resources in the following cases:
(a) when a recipient of medical assistance is aggrieved by the
				action or inaction of the Department as to any medical or remedial care or
				service which such recipient alleges should be reimbursed under the terms of
				the Georgia State Plan for Medical Assistance which was in effect on the date
				on which such care or service was rendered or is sought to be rendered;
(b) when an application for medical assistance is denied or is
				not acted upon with reasonable promptness;
(c) when a recipient or applicant has been aggrieved by an
				action or inaction of the Department or its agent with respect to a
				determination of the level of care status applicable to that person;
(d) when individuals are adversely affected by determinations
				made during the pre-admission screening or post-admission resident review
				required by Social Security Act °1919(e)(7), as amended, as implemented by
				Section 4211 of the Omnibus Budget Reconciliation Act of 1987;
(e) when an institution has received notice that it will
				be:
1. decertified to participate under the State Plan for Medical
				Assistance,
2. denied a license to operate a nursing facility, or
3. refused enrollment as a provider in the State Plan or
				terminated as a provider based on the want of any license, permit, certificate,
				approval, registration, charter or other form of permission issued by the
				Department of Human Resources;
(f) when a hearing is obtained pursuant to the provisions of
				Chapter 350-3 of these Rules; and
(g) when a recipient or applicant has been aggrieved by an
				action of the Department or its agent with respect to collection of funds paid
				in behalf of the recipient for medical services.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.03 - Right to Representation

Current through Rules and Regulations filed through June 27, 2024
(1) Providers may represent themselves, or may choose to be
				represented by legal counsel or any other spokesperson. However, providers may
				not be represented by employees or agents of the Department.
(2) An Administrative Law Judge may exclude from the hearing
				any person who:
(a) engages in unethical, disruptive, or contemptuous
				conduct;
(b) intentionally fails to comply with the proper instructions
				or orders of the Administrative Law Judge or the provisions of these Rules;
				and/or
(c) represents more than one party, in violation of any
				applicable authority regarding conflicts of interest.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.04 - Administrative Review

Current through Rules and Regulations filed through June 27, 2024
The Department shall offer the opportunity for Administrative
				Review to any provider against whom it proposes to take an adverse action
				unless the Department is otherwise authorized by law to take such action
				without opportunity for appeal by the provider prior to the action's
				implementation. The procedures and deadlines for obtaining such Administrative
				Review and the deadlines for decisions thereon shall be published in the
				Policies and Procedures Manual for each service category to which they apply.
				Administrative Review shall be completed, if not waived by the provider, prior
				to implementation of the proposed action. Whenever the opportunity for
				Administrative Review is available to the provider, such Administrative Review
				must be timely obtained and completed for the provider to be entitled to a
				hearing.
Ga. L. 1977, pp. 384,
				393; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.05 - Hearing Requests

Current through Rules and Regulations filed through June 27, 2024
(1) A request for a hearing must be in writing and received by
				the Department:
(a) within ten (10) days after the date on which a notice of
				denial of a request for enrollment or notice of suspension or termination was
				transmitted to the provider; or
(b) concerning any other action or inaction by the Department
				which aggrieves the provider, within ten (10) days after the date of the later
				of:
1. the Department's action for which the hearing is sought, if
				no opportunity for Administrative Review was available, or
2. notice of the final decision of the entity to which request
				for Administrative Review has been addressed.
In determining the timeliness of a request, the Department will
				compute the number of days in accordance with Rule  350-1-.01(24), if the date
				of the provider's receipt of notice of the adverse action being appealed is
				known to the Department; if the date of receipt by the provider is not known,
				the Department shall add five (5) days from the date of transmission of the
				notice to allow for delivery. Nothing herein shall bar proof of actual date of
				receipt by the provider or its agent, subject to the provisions of subsection
				19.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.06 - Dismissal of Hearing Requests

Current through Rules and Regulations filed through June 27, 2024
The Administrative Law Judge may dismiss a request for a
				hearing for the following reasons:
(a) it has been withdrawn by the provider in writing;
(b) there is no genuine issue of law or fact which requires a
				hearing determination;
(c) the provider without good cause therefor fails to appear in
				person by an authorized representative at the scheduled hearing, or the
				Administrative Law Judge determines that the provider's failure to comply with
				his directives or orders constitutes an abandonment of the request;
(d) there is a lack of jurisdiction over the subject matter or
				the parties;
(e) the party requesting the hearing has not been
				aggrieved;
(f) the parties have settled the matter prior to issuance of
				the Administrative Law Judge's decision;
(g) at the request of any party or on his own motion, the
				Administrative Law Judge determines that the requesting party has not met the
				prerequisites for obtaining a hearing, the case is not ripe for an
				Administrative Law Judge's determination, or the case has been rendered
				moot.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.07 - Informal Disposition; Settlement

Current through Rules and Regulations filed through June 27, 2024
(1) Informal disposition may be made of any contested case by
				stipulation, written agreement, or consent order.
(2) The parties may agree to settle the matters in dispute at
				any time prior to the issuance of the Administrative Law Judge's decision,
				whereupon the Administrative Law Judge shall dismiss the matter
				forthwith.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.08 - The Administrative Law Judge

Current through Rules and Regulations filed through June 27, 2024
(1) Each request for hearing meeting the specifications of
				Section  350-4-.06  shall be transmitted to an Administrative Law Judge appointed
				under authority of the Commissioner to adjudicate the matter in dispute.
(2) The Administrative Law Judge shall be a competent,
				qualified, and impartial individual who has not been involved in the action
				which has given rise to the hearing request. The Administrative Law Judge shall
				be an attorney who has a working knowledge of the Georgia Medicaid program
				and/or administrative law and the ability to conduct hearings in a competent
				manner. All Administrative Law Judges shall serve at the discretion of the
				Commissioner, who shall maintain uniform criteria for assessing each
				Administrative Law Judge's qualifications to serve.
(3) The Administrative Law Judge is vested with full authority
				in the conduct of the hearing process, and is responsible for conducting
				hearings in accordance with the Rules established by the Department.
(4) The Administrative Law Judge shall have the authority to do
				the following:
(a) administer oaths and affirmations;
(b) sign and issue subpoenas;
(c) rule upon offers of proof;
(d) regulate the course of the hearing and govern the conduct
				of the participants;
(e) rule on, admit, exclude, or limit evidence;
(f) examine witnesses;
(g) set the time and place for hearings and continuances
				thereof and fix the time for filing briefs and other documents;
(h) rule on all motions;
(i) provide for the taking of testimony by deposition or
				interrogatory;
(j) take official notice as prescribed in Rule  350-4-.19;
				and
(k) take any other action appropriate to dispose of the case in
				controversy.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.09 - Disqualification of the Administrative Law Judge

Current through Rules and Regulations filed through June 27, 2024
(1) An Administrative Law Judge shall voluntarily withdraw from
				any proceedings in which he cannot render a fair and impartial decision for any
				reason.
(2) A party may request the disqualification of an
				Administrative Law Judge by filing a written request or motion therefor
				accompanied by an affidavit stating in detail the grounds upon which it is
				claimed that a fair and impartial hearing cannot be given or that the
				Administrative Law Judge has an interest in the proceeding. The Administrative
				Law Judge shall immediately present the affidavit to the Commissioner of the
				Department who shall:
(a) investigate the allegation, advise the complaining party in
				writing of the decision granting or denying the request to disqualify the
				Administrative Law Judge, and mail a copy of the decision to all other parties;
				or
(b) reassign the case to another Administrative Law Judge
				without investigation.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.10 - Ex Parte Communications

Current through Rules and Regulations filed through June 27, 2024
Commencing with the appointment of an Administrative Law Judge,
				no person shall communicate
ex parte
with such Administrative
				Law Judge relating to the merits of the proceeding until after the issuance of
				a final decision unless all parties involved in the proceedings are informed of
				the communication before or within a reasonable time after such communication
				occurs and no prejudice to any party results. If the Administrative Law Judge
				receives a communication prohibited by this Rule, (s)he shall forthwith notify
				all other parties of the receipt of such communication and disclose the
				substance of the communication for the parties' consideration in determining
				whether action is necessary in response.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.11 - Notice of Hearing

Current through Rules and Regulations filed through June 27, 2024
As soon as practicable after being appointed to hear a case,
				the Administrative Law Judge shall issue a notice of hearing, stating the time
				and place of the hearing, the legal authority and jurisdiction pursuant to
				which the hearing was requested, the issues to be addressed, and the right of
				parties to subpoena witnesses and documentary evidence, to secure testimony by
				deposition or interrogatories when necessary, to be represented by legal
				counsel and to respond and present evidence on all issues involved. The notice
				may incorporate by reference information set forth in
				pleadings.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.12 - Pre-Hearing Conferences

Current through Rules and Regulations filed through June 27, 2024
(1) The Administrative Law Judge may, either
sua
				sponte
or at the request of any party, direct the parties or their
				authorized representatives to appear at a specified time and place for one or
				more conferences before or during a hearing or to submit written proposals or
				correspondence for the purpose of considering any of the matter set forth in
				Paragraph (2) of this Rule. At the discretion of the Administrative Law Judge,
				pre-hearing conferences may be conducted in whole or in part via
				telephone.
(2) In conferences held or in proposals submitted pursuant to
				Subsection (1) of this Rule, the following matters may be considered:
(a) settlement of the matter;
(b) the contemplated use of a schedule for the completion of
				prehearing procedures and the submission and disposition of all prehearing
				motions;
(c) simplification, clarification, amplification, or limitation
				of the issues;
(d) admissions and stimulations of facts and of the genuineness
				and admissibility of documents;
(e) the identity of persons expected to be called as witnesses
				by any party and the substance of their anticipated testimony;
(f) the identification of expert witnesses expected to be
				called by any party to testify, the substance of the facts and opinions to
				which an expert witness is expected to testify, and a summary of the grounds of
				each opinion;
(g) matters of which official notice by the Administrative Law
				Judge is sought;
(h) objections to the introduction into evidence at the hearing
				of any written testimony, documents, papers, exhibits, or other submissions
				proposed by any party; provided that, at any time before the end of the hearing
				on the merits any party may make and the Administrative Law Judge shall
				consider and either rule upon, or reserve a ruling upon, motions to strike
				testimony or other evidence on the grounds of relevance, competency or
				materiality; and
(i) such other matters as may expedite adjudication of the
				matter.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.13 - Time and Place of Hearing

Current through Rules and Regulations filed through June 27, 2024
(1) The hearing shall be conducted at the offices of the
				Department of Medical Assistance unless exigent circumstances necessitate a
				different venue, and at a reasonable time and date. Reasonable notice of the
				time and location shall be given to all parties prior to the scheduled hearing.
				In setting the hearing, the Administrative Law Judge shall consider those cases
				pending before other Administrative Law Judges, and shall accommodate the needs
				of the parties as far as practicable.
(2) The Administrative Law Judge may change the time and place
				of the hearing
sua sponte
, for good cause shown by any party,
				or per the mutual assent of all parties. Reasonable notice of such action shall
				be given to all parties.
Ga. L. 1977, p. 384, 391;
				O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.14 - Continued and Reopened Hearings

Current through Rules and Regulations filed through June 27, 2024
(1) The Administrative Law Judge may continue and/or reopen a
				hearing:
(a) on the Administrative Law Judge's own motion,
(b) at the request of any party, only upon a showing of good
				cause, or
(c) upon agreement by the parties.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.15 - Default; Abandonment

Current through Rules and Regulations filed through June 27, 2024
(1) If a party fails to appear at a hearing after receiving
				notice thereof, the Administrative Law Judge shall proceed with the hearing in
				the absence of the party or dismiss the action on motion of any party or
sua sponte.
(2) If the party requesting a hearing fails to take action to
				advance his case for a continuous period of two years, the request for hearing
				shall be deemed abandoned and shall be dismissed with prejudice by the
				Administrative Law Judge.
Ga. L. 1977, p. 384,
et seq.
; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.16 - Discovery

Current through Rules and Regulations filed through June 27, 2024
(1) Discovery is limited to the following.
(a) A party, upon written request made to another party within
				a reasonable time prior to the hearing, is entitled to:
1. obtain the names, addresses, and telephone numbers of the
				witnesses which the other party intends to call to testify at the
				hearing;
2. inspect and make a copy of all documents which the party
				proposes to offer into evidence.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.17 - Subpoenas

Current through Rules and Regulations filed through June 27, 2024
(1) The Administrative Law Judge shall have the authority to
				issue subpoenas requiring the attendance and testimony of witnesses and the
				production of objects or documents at depositions or hearing.
(2) Every subpoena shall be prepared by the requesting party
				and issued by the Administrative Law Judge on behalf of the Commissioner, shall
				state the title of the action, and shall command each person to whom it is
				directed to attend and give testimony or produce objects or documents in his
				possession or control or to do both at a time and place therein specified.
				Requests for subpoenas shall be filed at least five (5) days prior to the
				hearing or deposition at which the attendance of the witness or the production
				of the documents or objects is sought, unless there is good cause shown for
				submitting a request less than five (5) days in advance. The party requesting
				the subpoena shall be responsible for serving the same sufficiently in advance
				of the hearing to secure the attendance of the witness or the availability of
				such objects or documents at the title of the hearing.
(3) Failure of appearance by a witness, whether required by
				subpoena or not, may constitute grounds for a continuance or for other action.
				In determining what action to take, the Administrative Law Judge shall consider
				the materiality of the testimony, documents, or objects sought, potential
				prejudice and inconvenience to the parties, and the likelihood of obtaining
				compliance with a subpoena. The Administrative Law Judge may order whatever
				action he deems appropriate to the circumstances.
(4) When a subpoena is disobeyed, any party may apply to the
				superior court of the county where the case is being heard for an order
				requiring obedience. Failure to comply with such order shall be cause for
				punishment as for contempt of court.
Ga. L. 1977, pp. 384,
				391; O.C.G.A. Sec.  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.18 - Depositions

Current through Rules and Regulations filed through June 27, 2024
(1) At any time during the course of a proceeding, the
				Administrative Law Judge may, in his discretion, order that the testimony of a
				witness be taken by deposition. Application to take a deposition in lieu of
				personal appearance at the hearing shall be made by motion. Such motion shall
				state the name and address of the witness, the time when, the place where, and
				the subject matter about which the witness would be deposed, the relevance of
				such testimony, and the specific reason why the witness cannot or will not
				appear to testify at the hearing.
(2) In the exercise of his discretion in deciding whether to
				order testimony by deposition, the Administrative Law Judge shall consider,
				among other factors:
(a) whether requiring the appearance of a witness subject to
				subpoena would endanger that person's health or work an undue hardship;
				and
(b) whether ordering the taking of testimony by deposition will
				result in an undue cost or burden on any other party, an undue delay in the
				proceedings, or any injury to other parties from the delay.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.19 - Pleadings and Amendments; Automatic Filings

Current through Rules and Regulations filed through June 27, 2024
(1) The notice of adverse action issued by the Department and
				the request for hearing submitted by the provider shall constitute the
				pleadings in each contested case and automatically shall be included in the
				Record. The pleadings shall be transmitted by the Department to the
				Administrative Law Judge at the time of the Administrative Law Judge's
				appointment to the case.
(2) Any party may amend any pleading without leave of the
				Administrative Law Judge until the tenth day prior to the date set for the
				hearing on the matter. Thereafter a party may amend its pleadings only by
				written consent of the adverse party or by leave of the Administrative Law
				Judge. Leave shall be freely given when justice so requires. If an amendment is
				made to any pleading to which a response or reply is necessitated, a response
				or reply to such amendment shall be filed within ten days after service of the
				amended request or as otherwise ordered by the Administrative Law Judge.
(3) Copies of the notice of proposed adverse action issued by
				the Department and the request for Administrative Review filed by the provider
				which preceded the Pleadings shall be filed automatically by the Department
				with the Administrative Law Judge upon his appointment. Such filings shall
				include all supporting documentation transmitted therewith. All documents so
				filed shall automatically become part of the Record.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.20 - Rules of Evidence; Official Notice

Current through Rules and Regulations filed through June 27, 2024
(1) Relevant allegations of fact contained in the Pleadings and
				automatic filings shall be deemed admitted unless specifically
				contested.
(2) Irrelevant, immaterial, or unduly repetitious evidence
				shall be excluded. The rules of evidence as applied in the trial of civil,
				nonjury cases in the superior courts of Georgia shall be followed. When
				necessary to ascertain facts not reasonably susceptible of proof under such
				rules, evidence not admissible thereunder may be admitted, except where
				precluded by statute, if it is of a type commonly relied upon by reasonably
				prudent persons in the conduct of their affairs or if it consists of a report
				or evaluation of a type routinely submitted to or relied upon by the Department
				in the normal course of its business. The rules of privilege recognized by law
				shall be given full effect. Objections to evidentiary offers may be made and
				shall be noted in the record. Subject to these requirements, when a hearing
				will be expedited and the interests of the parties will not be prejudiced
				substantially, any part of the evidence may be received in written form.
(3) Documentary evidence may be received in the form of copies
				or excerpts if the original is not readily available or for the convenience of
				the parties if no substantial prejudice results thereby. Upon request, parties
				shall be given an opportunity to compare the proffered copy with the original
				to verify its correctness.
(4) Summaries of voluminous documents may be admitted into
				evidence, provided that the parties agree or the author of the summary is
				available for cross-examination. The summarized documents themselves need not
				be admitted into evidence, provided that all parties are accorded a reasonable
				opportunity to inspect the documents so summarized and no substantial injustice
				would result from admission of the summary alone.
(5) Official notice may be taken of judicially cognizable
				facts. In addition, official notice may be taken of generally recognized
				technical or scientific facts within the agency's specialized knowledge.
				Parties shall be notified either before or during the hearing, by reference in
				preliminary reports or otherwise, of the material requested to be noticed,
				including any staff memoranda or data, and they shall be afforded an
				opportunity to contest the material so noticed. The Department's experience,
				technical competence, and specialized knowledge may be utilized in the
				evaluation of the evidence.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.21 - Substitution of Parties; Intervention

Current through Rules and Regulations filed through June 27, 2024
(1) The Administrative Law Judge may, upon motion and in the
				exercise of discretion, permit such substitution of parties as justice
				requires, provided that the original party and the party to be substituted
				otherwise qualify individually as parties to the proceedings under all
				applicable requirements.
(2) Any person seeking to intervene shall file a motion stating
				therein the specific grounds upon which intervention is sought and a pleading
				setting forth the claim or defense for which intervention is sought. The person
				shall also establish the basis for qualification as a party to the proceedings.
				The Administrative Law Judge shall grant or deny such motion and may limit the
				factual or legal issues which may be raised by an intervenor in order to avoid
				undue delay or prejudice to the adjudication of the rights of the original
				parties.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.22 - Consolidation and Severance

Current through Rules and Regulations filed through June 27, 2024
(1) When two or more providers appeal matters involving common
				issues of law or fact, the appeals may be consolidated by the Department or by
				the appointed Administrative Law Judge(s) and heard together if it appears that
				a joint hearing would serve to expedite or simplify consideration of those
				issues and that no party would be prejudiced thereby.
(2) In consolidated hearings, the Administrative Law Judge may
				limit direct examination and cross-examination to matters which have not been
				adequately covered by previous testimony or evidence.
(3) Whenever the Administrative Law Judge determines that it
				would be more conducive to an expeditious, full, and fair hearing for any party
				or issue to be heard in separate proceedings, he may in the exercise of his
				discretion, upon motion of any party or
sua sponte
, sever the
				party or issue for such separate hearing.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.23 - Service

Current through Rules and Regulations filed through June 27, 2024
(1) The party filing any submission shall simultaneously serve
				a copy of each submission upon each party of record. Service shall be by mail
				or personal delivery. Service by mail shall be complete upon mailing by first
				class mail, with proper postage attached, to a party's address of
				record.
(2) Every submission shall be accompanied either by an
				acknowledgement of service from the person served or his representative, or by
				a document stating the date, place and manner of service and the name and
				address of the person served.
(3) The Administrative Law Judge shall return to the sender,
				without reviewing the contents thereof, any submission not accompanied by
				evidence of service as provided herein, along with an explanation for the
				return.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.24 - The Hearing

Current through Rules and Regulations filed through June 27, 2024
(1) The hearing shall be opened with reasonable promptness as
				fixed in the "notice of hearing."
(2) All Department hearings shall be accessible to the public,
				subject to requirements for safeguarding confidential information.
(3) In all hearings, taking of testimony shall be under
				oath.
(4) The rules applied to civil cases in the superior courts of
				Georgia concerning the burdens of persuasion and going forward with the
				evidence shall be followed.
(5) Both the provider and the Department shall have the
				opportunity to do the following:
(a) bring witnesses;
(b) establish all pertinent facts and circumstances through
				competent evidence;
(c) advance any arguments relevant to the proceedings without
				undue interference; and
(d) question or refute any testimony or evidence, including the
				opportunity to confront and cross-examine adverse witnesses.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.25 - Motions

Current through Rules and Regulations filed through June 27, 2024
(1) An application to the Administrative Law Judge for an order
				requiring any party to take any action or entering any interlocutory ruling
				shall be made by motion. Unless made during the hearing, motions shall be in
				writing, shall state specifically the grounds therefor, and shall describe the
				action or order sought. Motions that may be made in conformance with this Rule
				include, without being limited to, motions for more definite statement, for
				dismissal (
e.g.
, for lack of jurisdiction over the subject
				matter or parties, for failure to state a claim upon which relief may be
				granted or for any other ground), for summary determination, to amend, to
				intervene, to substitute parties, to consolidate or sever parties or issues, to
				take depositions or interrogatories, to secure testimony, or to re-open the
				Record to admit newly-discovered evidence. A copy of any written motion shall
				be served upon all parties in accordance with Section .23 of this
				Chapter.
(2) Within 20 days after service of any written motion, any
				party to the proceedings may file a response to the motion. The time for
				response may be shortened or extended by the Administrative Law Judge for good
				cause shown.
(3) The Administrative Law Judge may, either
sua
				sponte
or at the request of any party, determine in his discretion
				whether the nature and complexity of the motion justifies a hearing and notify
				the parties accordingly. A request for a hearing on a motion must be made in
				writing and filed by the date the response to the motion is to be filed. Notice
				of hearing on a motion shall be given by the Administrative Law Judge at least
				5 days prior to the date set for hearing unless such notice is waived by all
				parties. At the discretion of the Administrative Law Judge, such hearings may
				be conducted, in whole or in part, via telephone. If a hearing on a motion is
				not requested or deemed justified, the Administrative Law Judge shall rule upon
				the motion forthwith.
(4) Multiple motions may be consolidated for hearing or heard
				at a pre-hearing conference. The Administrative Law Judge may call for the
				submission of briefs, for oral argument, or both, either in support of or in
				opposition to any motion.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.26 - Summary Determination

Current through Rules and Regulations filed through June 27, 2024
(1) Any party may move, if supported by affidavits or other
				probative evidence, for a summary determination in its favor upon any of the
				issues being adjudicated on the basis that there is no genuine issue of
				material fact for determination. Such a motion must be filed and served on all
				parties no later than 20 days after service of the Notice of Hearing; provided
				that, upon good cause shown, the motion may be filed at any time before the
				close of the hearing.
(2) When a motion for summary determination is made and
				supported as provided in this Rule, a party opposing the motion may file and
				serve a response or a countermotion. The respondent may not rest upon mere
				allegations or denials, but must show, by affidavit or other probative
				evidence, that there is a genuine issue of material fact for determination in
				the hearing.
(3) Affidavits shall be made upon personal knowledge, shall set
				forth facts that would be admissible in evidence, and shall show affirmatively
				that the affiant is competent to testify to the matters stated therein. Copies
				of all papers or parts thereof referred to in an affidavit conforming to these
				rules shall be attached thereto and served therewith.
(4) If all factual issues are decided by summary determination,
				no hearing will be held and the Administrative Law Judge shall prepare a
				decision. If summary determination is denied or if partial summary
				determination is granted, the Administrative Law Judge shall issue a memorandum
				opinion and order, interlocutory in nature, and the hearing will proceed on the
				remaining issues.
O.C.G.A. Sec.
				  49-4-142(a), 153.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.27 - The Hearing Record

Current through Rules and Regulations filed through June 27, 2024
(1) The Administrative Law Judge shall compile an official
				Record of the hearing, which shall include:
(a) all pleadings, automatic filings, motions, and intermediate
				rulings;
(b) a transcript of the oral testimony received in
				evidence;
(c) all documents received in evidence;
(d) all depositions and interrogatories or excerpts therefrom
				admitted into evidence;
(e) a statement of matters officially noticed;
(f) all offers of proof, objections thereto, and ruling thereon
				not otherwise reflected in the transcript;
(g) all physical evidence admitted in the course of the
				hearing; and
(h) all demonstrative evidence admitted during the course of
				the hearing.
Compilation of Rules and Regulations of the State of Georgia › Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE › Chapter 350-4 - ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS › Rule 350-4-.28 - Decision of the Administrative Law Judge

Current through Rules and Regulations filed through June 27, 2024
(1) The decision of the Administrative Law Judge shall be based
				exclusively on competent evidence and other material introduced pursuant to
				this Chapter. It shall specify the reason for the decision and identify the
				supporting evidence and regulations, and include findings of fact and
				conclusions of law.
(2) The Administrative Law Judge's decision shall be issued to
				the Department within ninety (90) days from the Department's timely receipt of
				a hearing request conforming to the requirements of Rule  350-4-.05, and within
				thirty (30) days from the close of the Record. However, if, in the
				Administrative Law Judge's discretion, the complexities of the issues, the
				length of the case record, scheduling difficulties, agreement of the parties,
				or any other consideration justifies an extension of time, the Administrative
				Law Judge may extend the time in which an initial decision must be rendered;
				provided, however, that such extension shall not exceed ninety (90) days from
				the close of the Record.
(3) The Department shall, upon receipt of the Administrative
				Law Judge's decision, furnish a copy thereof to each party by Certified Mail,
				accompanied by a cover Notice informing each party of its appeal rights.
(4) The Administrative Law Judge's decision shall be accessible
				to the public, subject to requirements for safeguarding confidential
				information.
O.C.G.A. Sec.
				  49-4-142(a), 153.