reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.11 - NOTICE, TIME LIMITS, POSTPONEMENT, OR THE DISMISSAL OF A HSD ADMINISTRATIVE HEARING REQUEST

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Notice:
(1) In cases involving a
				PASRR determination or the determination to transfer or discharge the claimant
				from a NF, the notice of action is submitted by MAD, it UR contractor, the MCO
				or their designees. MAD, its UR contractor, the MCO or their designees shall
				issue a "notice of action" to an individual when it intends to take an adverse
				action against the individual. When the notice of action is concerning the LOC
				determination the MAP eligible recipient or the member currently has, the
				notice of action shall be sent not less than 10 calendar days prior to the date
				of MAD, its UR contractor, the MCO or their designee's intended adverse
				action.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.12 - SCHEDULING OF A HSD ADMINISTRATIVE HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Scheduling:
The ALJ will
				assign a date for a HSD administrative hearing that affords the MAD director
				the opportunity to render his or her HSD administrative hearing final decision
				within the 90 calendar day time limit. The claimant or the claimant's
				authorized representative must agree via a recorded message to the assigned ALJ
				or in writing to the assigned ALJ to extend the 90 calendar day time limit up
				to an additional 30 calendar days to provide the necessary time for the HSD
				administrative hearing to be conducted and a final decision rendered. The ALJ
				has the authority on a case-by-case basis to extent the 90-calendar day time
				limit to more than 30-calendar days when the claimant or the claimant's
				authorized representative requests such an extension in writing. If an
				accommodation is necessary for a disability, the claimant or the claimant's
				authorized representative must notify FHB at least 10 calendar days prior to
				the HSD administrative hearing.
B.
Rescheduling:
Any party to a HSD administrative hearing may
				request, and is entitled to receive, one postponement of a HSD administrative
				hearing, as long as it does not interfere with the HSD administrative hearing
				final decision time frames.
(1) A request for
				more than one postponement is at the ALJ's discretion on a case-by-case
				basis.
(2) The claimant or the
				claimant's authorized representative must agree to allow the ALJ to extend the
				90 calendar day time limit up to an additional 30 calendar days to provide the
				necessary time for the HSD administrative hearing to be conducted and a final
				decision rendered.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.13 - SUMMARY OF EVIDENCE (SOE)

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Summary of evidence.
(1) At a
				HSD administrative hearing, MAD has the burden to prove through the
				preponderance of the evidence that an adverse action against a claimant is
				correct. A summary of evidence (SOE) provides information concerning the basis
				of MAD, its UR contractor, the MCO or their designee's adverse action. MAD may
				have its UR contractor, HSD MCO or its designee complete an SOE for final
				review by MAD; however, MAD is ultimately responsible for the submission of its
				SOE. An SOE is submitted by MAD to the ALJ and claimant or the claimant's
				authorized representative within specified time-frames.
(2) A claimant or the claimant's authorized
				representative may submit a SOE to provide the ALJ with information to refute
				MAD's SOE. A claimant or the claimant's authorized representative is not
				required to provide a SOE as the burden of proof falls on MAD.
(3) The MAD SOE shall, at a minimum, contain:
(a) the claimant's name, and as applicable,
				his or her authorized representative's or legal counsel's telephone number and
				address, and the status of any previous or concurrent appeal through his or her
				MCO or MAD UR contractor;
(b) the
				adverse action against the claimant;
(c) the documentation supporting MAD, its UR
				contractor, the MCO or their designee basis for the intended or taken adverse
				action; and
(d) any applicable
				federal or state statutes, regulations, rules or any combination of these;
				however, that a failure by MAD, the UR contractor, the MCO or their designee to
				submit an applicable statute, regulation or rule shall not constitute per se
				grounds for the ALJ to find that MAD, the UR contractor, the MCO or their
				designee failed to meet its burden of proof.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.14 - ADMINISTRATIVE HEARING STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Administrative law judge.
(1) A
				HSD administrative hearing is conducted by an impartial official who:
(a) does not have any personal stake or
				involvement in the case; and
(b)
				was not involved in the determination or the action which is being contested;
				if the ALJ had any involvement with the action in question, including giving
				advice or consultation on the points at issue, or is personally related in any
				relevant degree to the parties, the ALJ must disqualify his or herself as the
				assigned ALJ for that case.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.16 - HSD ADMINISTRATIVE HEARING FINAL DECISION

Current through Register Vol. 35, No. 13, July 16, 2024
The final decision concerning the HSD administrative hearing
				  is made by the MAD director or designee after the review of the HSD
				  administrative hearing record and the ALJ's recommendation. If the ALJ had
				  rendered a decision to dismiss a HSD administrative hearing request, that
				  decision becomes the HSD administrative hearing final decision and the
				  following process detailed in this section of the rule does not apply.
A.
Decision based on the record:
The ALJ's HSD administrative hearing recommendation must be based solely on the
				record of the HSD administrative hearing.
B.
ALJ recommendation:
The ALJ
				shall review the record of the HSD administrative hearing and submit a complete
				copy of the record to the MAD director.
(1)
				Content of the ALJ recommendation: the ALJ shall specify the reasons for his or
				her conclusions, identifies the supporting evidence, references the pertinent
				federal and state statutes, regulations, and NMAC rules, and responds to the
				arguments of the parties within his or her written report.
(2) The ALJ recommends:
(a) in favor of the claimant if MAD, its UR
				contractor, the MCO or their designee's intended or taken adverse action is not
				supported by a preponderance of the evidence submitted during the HSD
				administrative hearing; the ALJ will provide specific recommendations to each
				appealed adverse action;
(b) in
				favor of MAD, if the preponderance of evidence submitted during the HSD
				administrative hearing supports the intended or taken of adverse action or
				actions; or
(c) any other result
				supported by the record of the HSD administrative hearing which may be a
				combination of recommendations for and against the claimant or MAD; if the HSD
				administrative hearing covered a number of services or components of a service,
				the ALJ will provide specific recommendations to each intended or taken adverse
				action.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.17 - CONTINUATION OF BENEFITS PURSUANT TO A TIMELY APPEAL AND A HSD ADMINISTRATIVE HEARING PROCEEDING

Current through Register Vol. 35, No. 13, July 16, 2024
The HSD administrative hearing final decision is binding on
				  all issues that have been the subject of the HSD administrative hearing as to
				  the claimant unless stayed by either a court order or by the MAD director or
				  designee. MAD is responsible for ensuring that the HSD administrative hearing
				  final decision is fulfilled.
A. If the
				claimant is a member and he or she received a benefit under his or her approved
				continuation of the benefit and the decision is favorable to the MCO, the
				claimant's MCO will not take action to file a repayment claim to the claimant
				or the claimant's authorized representative for the services received during
				the HSD administrative hearing process up to the date of the HSD administrative
				hearing final decision.
B. If the
				claimant is not enrolled in an MCO and the HSD administrative hearing final
				decision is favorable to MAD, MAD will not take action to file a repayment
				claim to the claimant or the claimant's authorized representative for the
				services received during the HSD administrative hearing process up to the date
				of the HSD administrative hearing final decision.
C. When the HSD administrative hearing final
				decision is favorable to the claimant, MAD, its UR contractor, the MCO or their
				designees will authorize the benefit and coverage set forth in the HSD
				administrative hearing final decision.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.18 - IMPLEMENTATION OF THE HSD ADMINISTRATIVE FINAL DECISION

Current through Register Vol. 35, No. 13, July 16, 2024
The HSD administrative hearing final decision is binding on
				  all issues that have been the subject of the HSD administrative hearing as to
				  the claimant unless stayed by either a court order or by the MAD director or
				  designee. MAD is responsible for ensuring that the HSD administrative hearing
				  final decision is fulfilled.
A. If the
				claimant is a member and he or she received a benefit under his or her approved
				continuation of the benefit and the decision is favorable to the MCO, the
				claimant's MCO will not take action to file a repayment claim to the claimant
				or the claimant's authorized representative for the services received during
				the MCO appeal and the HSD administrative hearing process up to the date of the
				HSD administrative hearing final decision.
B. If the claimant is not enrolled in an MCO
				and the HSD administrative hearing final decision is favorable to MAD, its UR
				contractor or designee, MAD will not take action to file a repayment claim to
				the claimant or the claimant's authorized representative for the services
				received during the HSD administrative hearing process up to the date of the
				HSD administrative hearing final decision.
C. When the HSD administrative hearing final
				decision is favorable to the claimant, MAD, its UR contractor, the MCO or their
				designee will authorize the benefit and coverage set forth in the HSD
				administrative hearing final decision.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 354 - PREADMISSION SCREENING AND ANNUAL RESIDENT REVIEW (PASRR) AND PATIENT STATUS POLICIES › Part 2 - PASRR AND PATIENT STATUS HEARINGS › Section 8.354.2.19 - JUDICIAL APPEAL

Current through Register Vol. 35, No. 13, July 16, 2024
If the HSD administrative hearing final decision upholds MAD,
				  its UR contractor, the MCO or their designee's intended or taken adverse
				  action, the claimant or the claimant's authorized representative has the right
				  to pursue judicial review of the HSD administrative hearing final decision and
				  is notified of that right in the HSD administrative final decision letter.
				  Judicial appeals for the HSD administrative hearing final decision are governed
				  by New Mexico statutes and court rules. While the following subsections
				  highlight applicable procedures, they should not be considered a substitute for
				  examining the statutes and rules themselves.
A.
Jurisdiction:
Administrative
				appeals for a claimant are governed by the Section
				39-3-1.1
				NMSA 1978 and by Rule 1-074, Rules of Civil Procedures for the district
				courts.
B.
Timeliness:
Unless otherwise provided by law, a claimant or the claimant's authorized
				representative must appeal the HSD administrative hearing final decision within
				30 calendar days of the date of the HSD administrative hearing final decision
				by filing a notice of appeal with the clerk of the appropriate New Mexico
				district court.
C.
Jurisdiction and standard of review:
All judicial appeals are
				based on the record made at the HSD administrative hearing, and in accordance
				with state statute and court rules. HSD files a copy of the HSD administrative
				hearing record with the court clerk and furnishes one copy to the claimant or
				the claimant's authorized representative and if applicable, his or her legal
				counsel within 30 calendar days after receipt of the notice of appeal. The
				court may set aside the HSD administrative hearing final decision if it finds
				the decision is:
(1) arbitrary, capricious,
				or an abuse of discretion;
(2) is
				not supported by substantial evidence in the record as a whole; or
(3) is otherwise not in accordance with the
				applicable law, statutes or rules.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
This rule is promulgated and issued by the New Mexico Health
				  Care Authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
Except as otherwise specifically provided by statute or rule,
				  the scope of the sections in this part apply to adjudicatory proceedings
				  conducted by the authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
This rule is promulgated by the secretary of the New Mexico
				  health care authority (authority), pursuant to the authority granted under
				  Section 9-8-1 et seq. NMSA 1978 which establishes the health care authority as
				  a single, unified department to administer laws and exercise functions relating
				  to health care facility licensure and health care purchasing and regulation;
				  the authority granted pursuant to
				  42 U.S.C. Section
				  1396a(i); the authority
				  granted under 42 C.F.R.
				  Sections 431.151 through
				  431.154;
				  442.118; and 8.353.2.9 NMAC, based
				  on sanctions imposed by the authority on licensed facilities in which medicaid
				  recipients receive services. This rule does not provide adjudicatory procedures
				  for appeals from actions related to the home and community based
				  waiver.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule becomes effective on July 1, 2024, unless a later
				  date is cited at the end of a section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule provides adjudicatory procedures for licensed
				  health facilities: administrative appeals of the initial denial of an annual
				  license; of an emergency prehearing suspension of license and of emergency
				  intermediate sanctions; of authority action denying renewal, suspending, or
				  revoking a license, or of the authority's imposition of an intermediate
				  sanction or civil monetary penalty; and of a cease and desist
				  order.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.8 - STANDARD OF COMPLIANCE

Current through Register Vol. 35, No. 13, July 16, 2024
The degree of compliance required by this rule is designated
				  by the use of the words "shall" or "must" and "may". "Shall" and "must"
				  designate mandatory requirements; "may" is permissive.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.9 - USAGE

Current through Register Vol. 35, No. 13, July 16, 2024
The singular number includes the plural, and the plural
				  includes the singular.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.10 - SEVERABILITY

Current through Register Vol. 35, No. 13, July 16, 2024
If any portion of this rule or the application of this rule,
				  is held to be invalid, the validity of the remainder of the regulations, or the
				  application of the regulations to different situations or persons, shall not be
				  affected.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.11 - HEARING PROCESS AND PROCEDURES GROUNDS FOR REQUESTING HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
The actions or proposed actions of the authority which may
				  be contested are:
A. denial of an
				application for initial annual license;
B. denial of an application for renewal of an
				annual license;
C. a cease and
				desist order;
D. emergency
				suspension of license (pre-hearing);
E. suspension of license (non-emergency,
				posthearing);
F. revocation of
				license;
G. intermediate sanctions
				or civil monetary penalties.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.12 - INITIATION OF HEARING PROCESS

Current through Register Vol. 35, No. 13, July 16, 2024
The hearing process is begun upon receipt by the licensing
				  authority of a timely request for hearing, or, in the case of a prehearing
				  emergency suspension of license, by service upon the licensee of an emergency
				  suspension order and notice of hearing.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.13 - REQUEST FOR HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
A. Written and
				signed: the request for hearing shall be made in writing and shall be signed by
				the person or an authorized representative of the person against whom the
				action of the authority is taken.
B. Delivery: the request for hearing shall be
				addressed to the director of the division of health improvement or to any other
				authority employee indicated in the authority's notice, and it shall be hand
				delivered or mailed, return receipt requested, to such person.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.14 - TIME FOR REQUESTING HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
The request for hearing must be received by the
				  authority:
A. within 10 working days
				after receipt by the initial applicant, renewal applicant or prospective
				licensee of notice of the decision denying the application for
				license;
B. within five working
				days after receipt of a cease and desist order;
C. within 10 working days after receipt by
				the licensee of a notice of suspension or notice of revocation;
D. within four working days after receipt by
				the licensee of an emergency suspension order or emergency intermediate
				sanction and notice of hearing (pre-hearing emergency suspension of
				license).
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.15 - EFFECT OF REQUEST FOR HEARING; STAY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Denial of an initial annual license:
				receipt by the licensing authority of a timely request for hearing upon the
				denial of an initial annual license does not allow the facility to begin
				operation. If the facility begins operation without a license, it is operating
				illegally and is subject to appropriate administrative and judicial sanctions
				and criminal charges.
B. Denial of
				renewal of annual license: receipt by the licensing authority of a timely
				request for hearing upon the denial of renewal of an annual license stays the
				expiration of the current license until a final decision.
C. Cease and desist order: receipt by the
				licensing authority of a timely request for hearing following issuance of a
				cease and desist order does not allow a facility to operate.
D. Emergency suspension of license: if the
				licensee intends to appear for the five-day hearing noticed in the emergency
				suspension order and notice of hearing, a request for hearing need not be made.
				If the licensee timely waives the five-day hearing and requests a hearing to be
				held at a later date, the effect of such waiver is to allow time for additional
				prehearing discovery. Such waiver and request for later hearing does not stay
				the emergency suspension. The facility operates without legal authority if it
				continues operation after the effective date of the emergency suspension and
				becomes subject to appropriate administrative and judicial sanctions and
				criminal charges.
E. Suspension,
				revocation, intermediate sanctions and civil monetary penalties: receipt by the
				licensing authority of a timely request for hearing following notice of the
				suspension or revocation of a current license stays suspension or revocation of
				the license until a final decision is reached following the hearing.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.16 - SCHEDULING HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
A. Scheduling:
				promptly upon receipt of a timely request for hearing, the authority shall
				schedule a hearing to be held in Santa Fe, unless the hearing is required to be
				held elsewhere by applicable regulation.
B. Change of location: upon timely motion,
				and with a showing of undue hardship and burden, the hearing officer may order
				the hearing location changed.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.17 - HEARING OFFICER

Current through Register Vol. 35, No. 13, July 16, 2024
A. Designation
				of hearing officer: promptly upon receipt of a timely request for hearing, the
				secretary or authorized representative of the authority shall designate a
				hearing officer.
B. Qualifications:
				the hearing officer shall be impartial and shall have no personal bias or
				interest in the matter to be heard. He or she may be an officer or employee of
				the New Mexico health care authority as long as he was not involved in making
				the challenged administrative decision. The hearing officer need not be a
				licensed attorney, however, he should have relevant experience with
				evidentiary, adjudicatory proceedings.
C. Disqualification: a hearing officer
				designated to preside at the hearing may disqualify himself on their own
				motion, or upon written request to, and approval of, the secretary of the New
				Mexico health care authority.
D.
				Party's request for disqualification: whenever any party deems the hearing
				officer to be disqualified to preside, such party may file a written request to
				disqualify with the secretary of the New Mexico health care authority. The
				request shall be supported by affidavits setting forth the grounds for
				disqualification. The secretary shall promptly determine the validity of the
				grounds alleged and take appropriate action.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.18 - DUTIES OF HEARING OFFICER

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Official file: upon appointment, the hearing officer shall establish an
				official file which will contain all the filed notices, pleadings, briefs,
				recommendations, correspondence and decisions. It shall also contain the
				authority's notice of action as well as the request for hearing. Upon
				conclusion of the proceeding and following issuance of the final decision, the
				hearing officer shall turn over to the authority this official file for future
				custody.
B. Preside at hearing: the
				hearing officer shall preside over the hearing, administer oaths, take evidence
				and decide evidentiary objections and any motions or other matters that arise
				prior to or during the hearing.
C.
				Evidence file: the hearing officer shall maintain an evidence file with each
				document or item admitted into evidence. Proffered items not admitted into
				evidence, at the request of the offering party, shall be so identified and
				separately maintained by the hearing officer.
D. Subpoenas: the hearing officer, upon
				request by a party, may issue subpoenas and subpoenas duces tecum.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.19 - PARTIES

Current through Register Vol. 35, No. 13, July 16, 2024
The principal and original parties to a hearing conducted
				  under this rule shall be the appropriate agency of the authority, and the
				  applicant or prospective licensee, the licensee, licensed medicaid provider
				  applicant, or the recipient of a cease and desist order, depending upon the
				  nature of the hearing. Generally, intervenors are not allowed to participate as
				  a party.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.20 - LEGAL REPRESENTATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Natural persons: natural persons may appear on their own behalf or by an
				attorney licensed to practice in New Mexico.
B. Entities: the authority, corporations and
				other organizations and entities may appear by a bona fide officer, employee or
				representative or may be represented by an attorney licensed to practice in New
				Mexico.
C. Filing: any party filing
				documents in the appeal shall sign the original and hand deliver or mail it to
				the hearing officer and shall hand deliver or mail copies to all other
				parties.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.21 - DISCOVERY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Minimum
				discovery; inspection and copying of documents: each party shall have access to
				the relevant documents in the possession of the other party, except
				confidential or privileged documents. Access to the authority's relevant
				documents may be had during normal business hours at the authority's
				appropriate business offices. A reasonable copying fee may be
				charged.
B. Minimum discovery;
				witnesses: the parties shall each disclose to each other orally or in writing
				and to the hearing officer, the names of witnesses to be called, together with
				a brief summary of the testimony of each witness. In situations where
				statements will be presented to the hearing officer, rather than witnesses
				examined, the names of the persons making the statements and the summary of the
				statements, shall be disclosed.
C.
				Additional discovery: at the hearing officer's discretion, upon a written
				request by a party which sets out reasons that additional discovery is needed,
				further discovery in the form of production and review of documents and other
				tangible things, examinations and premise inspections, interviews or written
				interrogatories may be ordered. In exercising their authority to determine
				whether further discovery is necessary or desirable, the hearing officer should
				consider whether the complexity of fact or law reasonably requires further
				discovery to ensure a fair opportunity to prepare for the hearing and whether
				such request will result in unnecessary hardship, cost, or delay in holding the
				hearing.
D. Costs: cost of document
				copying, mail or delivery service, interviews or written interrogatories,
				including mileage and per diem, paid in accordance with the New Mexico Per Diem
				and Mileage Act (Section 10-8-1, NMSA 1978) shall be paid by the requesting
				party.
E. Depositions prohibited:
				oral or written depositions are not permitted.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.22 - PREHEARING CONFERENCE

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Purpose: at the discretion of the hearing officer, upon request of a party or
				upon the hearing officer's own motion, a prehearing conference shall be
				scheduled by the hearing officer at a time and place reasonably convenient to
				all parties, in order to: limit and define issues; discuss possible prehearing
				disposition; consider possible stipulations of factual or legal issues, or
				stipulations concerning the admissibility of evidence; limit the testimony or
				the number of witnesses, the issues or the evidence; and, discuss such other
				matters as may aid in the simplification of evidence and disposition of the
				proceedings.
B. Informal: such a
				conference shall be informal. No offer of settlement made at the conference
				shall be admissible in evidence at any later hearing. Stipulations and
				admissions shall be binding and may be used as evidence at the hearing. At the
				hearing officer's discretion, stipulations and admissions may be made in
				writing and filed with the hearing officer as part of the official record of
				the proceedings.
C. Notice: the
				hearing officer will give notice of the time and place of the pre-hearing
				conference to the parties by telephone, in person or by mail.
D. Costs: each party shall bear its own
				costs, including transportation costs.
E. Record: a record of the prehearing
				conference shall not be kept. A prehearing order or other pleadings may be
				filed as a result of the prehearing conference.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.23 - PREHEARING DISPOSITION

Current through Register Vol. 35, No. 13, July 16, 2024
The subject matter of any hearing may be disposed of by
				  stipulation, settlement or consent order, unless otherwise precluded by law.
				  Any stipulation, settlement or consent order reached between the parties shall
				  be written, signed by the hearing officer and the parties or their attorneys,
				  and submitted to the secretary of the New Mexico health care authority. Such
				  prehearing disposition shall be effective only if approved by the
				  secretary.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.24 - POSTPONEMENT OR CONTINUANCE

Current through Register Vol. 35, No. 13, July 16, 2024
The hearing officer in their discretion, may postpone or
				  continue a hearing upon their own motion or upon motion of a party, for good
				  cause shown. Notice of any postponement or continuance shall be given in
				  person, by telephone, or by mail to all parties within a reasonable time in
				  advance of the previously scheduled hearing date.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.25 - ADDITIONAL PLEADINGS

Current through Register Vol. 35, No. 13, July 16, 2024
Solely at the discretion of the hearing officer, pleadings,
				  motions and briefs allowed in the state district courts of New Mexico may be
				  filed.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.26 - CONDUCT OF THE HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
A. Public: all
				hearings shall be open to the public, unless a closed hearing is asked for by
				the person requesting the hearing and the hearing officer finds good cause
				exists for closing the hearing. The authority shall not request a closed
				hearing.
B. Powers of hearing
				officer: the hearing officer shall have all the powers necessary to conduct a
				hearing and to take all necessary action to avoid delay, maintain order, and
				assure development of a clear and complete record, including but not limited to
				the power to: administer oaths or affirmations on the request of any party;
				schedule continuances; examine witnesses and direct witnesses to testify; limit
				repetitious and cumulative testimony; and set reasonable limits on the amount
				of time a witness may testify; decide objections to the admissibility of
				evidence or receive the evidence subject to later ruling; receive offers of
				proof for the record; direct parties to appear and confer for the settlement or
				simplification of issues, and to otherwise conduct prehearing conferences;
				dispose of procedural requests or similar matters; and, enter findings of fact,
				conclusions of law, orders, and reports and recommendations.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.27 - ORDER OF PRESENTATION; GENERAL RULE

Current through Register Vol. 35, No. 13, July 16, 2024
Except as specifically provided in the following section, the
				  order of presentation for hearings in all cases, including but not limited to
				  those arising from suspension, revocation, denial of renewal of license,
				  intermediate sanctions, civil monetary penalties, emergency suspension,
				  emergency intermediate sanctions shall be:
A. appearances: opening of proceeding and
				taking of appearances by the hearing officer;
B. pending matters: disposition by the
				hearing officer of preliminary and pending matters;
C. opening statements: the opening statement
				of the authority; and then the opening statement of the licensee or the party
				challenging the authority's action;
D. cases: the authority's case-in-chief; and
				then the case-in-chief of the licensee or the party challenging the authority's
				action;
E. rebuttal: the
				authority's case-in-rebuttal;
F.
				closing argument: the authority's closing statement, which may include legal
				argument; and then the closing statement, which may include legal argument of
				the licensee or the party challenging the authority's action; and
G. close: closing of proceedings by the
				hearing officer.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.28 - ORDER OF PRESENTATION; SPECIAL CASES RULE

Current through Register Vol. 35, No. 13, July 16, 2024
The order of presentation in denial of an initial annual
				  license and cease and desist order cases is:
A. appearances: opening of proceeding and
				taking of appearances by the hearing officer;
B. pending matters: disposition by the
				hearing officer of preliminary and pending matters;
C. opening statements: applicant's or
				recipient's opening statement; and then the opening statement of the licensing
				authority;
D. cases: the
				applicant's or recipient's casein-chief; and then the licensing authority's
				case-in-chief;
E. rebuttal: the
				applicant's/prospective licensee's or recipient's case-in-rebuttal;
F. closing argument: the
				applicant's/prospective licensee's or recipient's closing statement, which may
				include legal argument; and then the licensing authority's closing statement,
				which may include legal argument; and
G. close: closing of proceedings by the
				hearing officer.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.29 - BURDEN OF PROOF

Current through Register Vol. 35, No. 13, July 16, 2024
A. General
				rule: except as specifically provided for in the following paragraph, in all
				cases, including but not limited to those arising from suspension, revocation,
				denial of renewal of license, intermediate sanctions, civil monetary penalties,
				emergency suspension, emergency intermediate sanctions, or medicaid provider
				appeals, the authority shall present evidence supporting its decision. The
				party challenging the authority's decision shall then present evidence to show
				that the authority's decision is incorrect. The burden of proving by a
				preponderance of the evidence the basis for the decision at issue rests with
				the authority.
B. Special cases: in
				cases arising from the denial of initial license and cease and desist orders,
				the applicant for initial license or the recipient of the cease and desist
				order shall present evidence supporting the license application, or evidence
				supporting the legality of operating without a license. The licensing authority
				shall then present evidence supporting the denial of the application, or
				evidence of the propriety and of cease and desist order. The burden of proving
				by a preponderance of the evidence:
(1) that
				the application was improperly denied by the licensing authority and should be
				approved, or
(2) that operation is
				proper and in accordance with law, rests with the license applicant or
				recipient of the cease and desist order.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.30 - EVIDENCE

Current through Register Vol. 35, No. 13, July 16, 2024
A. Technical rules
				not applicable: in general, the technical rules of evidence, such as the New
				Mexico rules of evidence, shall not apply but may be used as a guide to the
				principles of evidence and may be considered in determining the weight to be
				given any item of evidence. Nonprivileged, material and relevant evidence of
				the type which is relied upon by reasonably prudent persons in the conduct of
				serious affairs is admissible. The hearing officer may exclude, either with or
				without formal objection, unreliable, immaterial, irrelevant and unduly
				repetitious testimony and evidence.
B. Objections: a party may timely object to
				evidentiary offers by stating the objection together with a succinct statement
				of the grounds. The hearing officer may rule on the admissibility of evidence
				at the time an objection is made or may receive the evidence subject to later
				ruling.
C. Official notice:
				official notice may be taken of all facts of which judicial notice may be
				taken. Any party shall, on timely request, be afforded an opportunity to
				contest the noticed fact.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.31 - EVIDENCE FROM WITNESSES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Statement or examination of witnesses: the hearing officer, at their
				discretion, may receive evidence in the form of statements where a party is not
				represented by counsel; otherwise, the normal manner of witness testimony shall
				be by direct examination, cross examination and redirect examination, and
				through questioning by the hearing officer.
B. Written form: any part of the evidence may
				be received by the hearing officer in writing when a hearing will be expedited
				and the interests of the parties will not be substantially
				prejudiced.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.32 - RECORD

Current through Register Vol. 35, No. 13, July 16, 2024
A. Content: the
				record of a proceeding under this rule shall include all documents contained in
				the official files maintained by hearing officer, including findings of fact
				and conclusions of law, the recommendations of the hearing officer; and the
				final decision of the secretary.
B.
				Recording the hearing: proceedings at which evidence is presented orally shall
				be recorded by means of a mechanical or electronic sound recording device
				provided by the authority. Such recording need not be transcribed, unless
				requested by a party who shall arrange and pay for the transcription. Any party
				who seeks judicial review, in conformity with applicable appellate rules, must
				request leave to file the audio tapes of the administrative proceeding as the
				transcript of the proceedings together with the necessary copies made and
				certified as true and correct by an authorized employee of the
				authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.33 - REPORT AND RECOMMENDATION OF HEARING OFFICER

Current through Register Vol. 35, No. 13, July 16, 2024
A. Hearing officer's report shall contain: a
				statement of the issues raised at the hearing; findings of fact and conclusions
				of law, applying law and regulations to the facts. Findings of fact shall be
				based on the evidence presented at the hearing or known to all parties,
				including matters officially noticed; and recommended determination.
B. Submission for final decision: the hearing
				officer's report together with the full hearing record shall be submitted to
				the secretary of the New Mexico health care authority for a final
				determination. The report and recommendation shall be submitted within 30
				working days after expiration of the time set for submittal of the last post
				hearing submission of requested findings and conclusions, arguments or
				briefs.
C. Optional announcement of
				decision: at the close of the hearing, the hearing officer may announce their
				decision and request that the parties prepare appropriate post hearing
				submissions, including a decision for approval by the hearing officer. The
				hearing officer's oral and written decision is a recommendation to the
				secretary of the New Mexico health care authority and is not a final
				order.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.34 - FINAL DECISION

Current through Register Vol. 35, No. 13, July 16, 2024
The secretary of the authority shall render a final
				  administrative determination within ten working days of the submission of the
				  hearing officer's report. Parties may be notified personally, by telephone or
				  by mail of the final order. A copy of the final decision shall be mailed to
				  each party or attorney of record.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.35 - FAILURE TO APPEAR

Current through Register Vol. 35, No. 13, July 16, 2024
A. Default:
				failure of the party requesting the hearing to appear on the date and at the
				time set for hearing, without good cause shown, shall constitute a default and
				the hearing officer shall so notify all parties in writing.
B. Entry of decision: the hearing officer
				shall enter such findings, conclusions, decisions, recommendations, rulings and
				orders as are appropriate.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.36 - PERSONAL SERVICE

Current through Register Vol. 35, No. 13, July 16, 2024
Whenever this rule requires or allow delivery of notice of
				  administration action or proposed action by way of personal service, such
				  service shall be made by a licensing authority employee or other authority
				  representative, or by any individual over the age of 18
				  years.