New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 352 - ADMINISTRATIVE HEARINGS › Part 3 - PROVIDER HEARINGS › Section 8.352.3.11 - PRE-HEARING PROCEDURE

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Notice of hearing:
Not less than 30 calendar days before the
				provider administrative hearing, written notice is given to all parties
				involved of the time, date, and place of the hearing. If an accommodation is
				necessary, the party must notify the assigned ALJ at least 10 calendar days
				prior to the hearing. The FHB includes in its written notice to the provider an
				explanation of the HSD provider administrative hearing process and procedures,
				and informs the provider HSD does not pay fees or costs incurred by the
				provider as a result of the provider administrative hearing or district court
				appeals of the final HSD provider administrative hearing decision.
B.
Postponement:
A provider may
				request, and is entitled to receive, one postponement of the scheduled provider
				administrative hearing, as long as it does not interfere with the 120 calendar
				day timeframe. Requests for more than one postponement are considered on a
				case-by-case basis at the ALJ's discretion.
C.
Expedited hearing:
The
				parties may request an expedited hearing in cases involving a medical
				assistance program (MAP) eligible recipient's health, safety, or service
				availability concerns. The request must be made in writing and state in detail
				the reasons why an expedited hearing is necessary. Granting an expedited
				hearing is at the discretion of the ALJ.
D.
Group hearing:
The ALJ may
				respond to a series of individual requests for hearings by conducting a single
				group hearing. In all group hearings, the HSD administrative hearing process
				governing an individual hearing is followed. Each provider, his or her
				authorized representative or legal counsel may present his or her case
				individually. If a group hearing is arranged, each affected provider has the
				right to withdraw from the group hearing in favor of an individual HSD provider
				administrative hearing.
E.
Informal resolution conference:
The parties are encouraged to hold an
				informal resolution conference before the provider administrative hearing to
				discuss the issues involved in the hearing. The informal resolution conference
				is optional and does not delay or replace the provider administrative hearing
				process. Conference participants may include the provider, his or her
				authorized representative or legal counsel, MAD or other responsible agency
				representatives, and the MAD selected claims and provider enrollment processing
				contractor. The purpose of the informal resolution conference is to informally
				review MAD's action and to determine whether the issues can be resolved by
				mutual agreement. The issues to be decided at the provider administrative
				hearing may also be clarified or further defined. Regardless of the outcome of
				the informal resolution conference, a provider administrative hearing is still
				held, unless the provider submits a written withdrawal of the request of the
				provider administrative hearing.
F.
Pre-hearing conference:
The
				assigned ALJ schedules a pre-hearing conference within 30 calendar days of the
				receipt of the provider's request for a HSD provider administrative hearing. A
				pre-hearing conference is an informal proceeding and may occur telephonically.
(1)
Purpose of conference:
The
				purposes of the pre-hearing conference include, but are not limited to:
(a) expediting the disposition of the
				action;
(b) identification,
				clarification, formulation and simplification of issues;
(c) resolution of some or all
				issues;
(d) exchange of documents
				and information;
(e) preparing
				stipulations of fact to avoid unnecessary introduction of evidence at the
				hearing;
(f) review of audit
				findings;
(g) reconsideration of a
				suspension or withholding of payments;
(h) identifying the number of witnesses;
				and
(i) facilitating the settlement
				of the case.