Mont. Admin. R. 37.5.311 - INFORMAL RECONSIDERATION
(1) A
provider or other person may request an informal reconsideration of a
department action in the following cases:
(a)
where the hearing is to be held after the effective date of a denial,
termination, or nonrenewal of enrollment, certification, or
registration;
(b) where the
department intends to withhold or suspend payments to a medical assistance
provider pursuant to ARM
37.85.513; or
(c) as otherwise provided by department
rule.
(2) The informal
reconsideration includes:
(a) written notice
to the provider of the department action and the findings upon which it was
based, if not otherwise already provided;
(b) the provider's written refutation of the
department's findings, which must be received by the department within 15 days
after mailing of the department's notice under (2)(a); and
(c) the department's written determination
modifying, affirming, or reversing its decision.
(3) This rule does not require that the
informal reconsideration or any hearing be conducted prior to the department
action.
(4) An informal
reconsideration under this rule is not subject to the provisions of the Montana
Administrative Procedure Act, Title 2, chapter 4, MCA.
(5) An informal reconsideration is a
different and separate form of procedure from an administrative review and/or
fair hearing. A provider or other person is not entitled to an administrative
review, fair hearing, or other process in addition to an informal
reconsideration unless specifically provided by department rule or otherwise
required by law.
Notes
53-2-201, 53-2-606, 53-4-212, 53-6-113, 53-7-102, MCA; IMP, 53-2-201, MCA;
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