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UNOFFICIAL 1736-27 all parties. The decision of the hearing officer and any appeal made to the DHS director shall be subject to judicial review as provided in section 91-14, HRS. [Eff 08/01/94 ] (Auth: HRS §346-14; 42 C.F.R. §431.10) (Imp: HRS §346-14; 42 C.F.R. §§455.13, 455.16)
§§17-1736-47 to 17-1736-56 (Reserved).
§17-1736-57 Determination of medicaid reimbursement for hospital and institutional providers. The provider shall be notified of the reimbursement determination (NPR) and notice of PPS rate through the fiscal agent. The notices shall be sent to the provider by certified mail. [Eff 08/01/94 ] (Auth: HRS §346-14; 42 C.F.R. §431-10) (Imp: 42 C.F.R. §431.10)
§17-1736-58 Hospital and institutional provider's right to review. (a) A provider may request an administrative hearing if it is dissatisfied with the department's determination of medicaid reimbursement: (1) Following any request for rate reconsideration determination under PPS; or (2) Following the issuance of an NPR under cost reimbursement; and (3) The amount in dispute is at least $1,000.
(b)A written request for administrative hearing must be…#
(b) A written request for administrative hearing must be received by the department within ninety days from the date of the rate reconsideration determination or NPR as provided in subsection (a) and shall refer to that specific notification.
(c)The provider's request for an administrative hearing…#
(c) The provider's request for an administrative hearing shall include the following: (1) Individual adjustment items and the specific reimbursement issue and the dollar amount entailed; (2) The reasons for the disagreement; (3) Any material or evidence the provider considers necessary to support its position; and (4) The notice with which the provider disagrees.