(a) Time limit for appeals.

1. (1)

   1. (A) Any long-term care facility may appeal the facility’s reimbursement rate, a recoupment, a cost disallowance, a fine, a sanction, the imposition of a civil money penalty, or suspension or termination from the program by submitting a written notice of appeal to the Secretary of the Department of Human Services within thirty (30) calendar days following the date of the appealed action.
   2. (B) The appeal must clearly state the basis for appeal and must be accompanied by supporting documentation.
   3. (C) If the facility wishes to utilize the mediation process as contained in this section, it must so state in its written notice of appeal.

2. (2)

   1. (A)

(i) If an appeal is filed, the secretary or his or her designee will appoint an independent hearing officer to hear the appeal.

1. (ii) The hearing officer will schedule all appeals within sixty (60) days of receipt of written notice of appeal by the Division of Medical Services and will notify the parties in writing of the hearing schedule.

   1. (iii)

(b) (b) However, the appealing facility and the secretary or his or her designee shall implement the mediation process within the sixty (60) days.

1. (c) (c) Upon the termination of the mediation process, if any dispute stated in the notice of appeal remains unresolved, the secretary or his or her designee will appoint the independent hearing officer within sixty (60) days of the termination.

   1. (d) (d) The hearing officer will set a discovery schedule if requested by either party. Either party may request a continuance for good cause.

(f) (f) The hearing officer will render a written decision within thirty (30) days of the hearing and furnish a copy of the decision to the parties or their representatives.

1. (B)

   1. (i) Any objection requesting disqualification of the hearing officer upon allegations of personal interest or bias must be made in writing, supported by good faith affidavit, and submitted to the secretary at least fifteen (15) days before the scheduled hearing.

      1. (ii) The secretary will consider the objection promptly and rule on it in a timely manner.

(b) Administration of appeal.

1. (1)

   1. (A) The appellant may:

      1. (i) Be present at the hearing;
      2. (ii) Be represented by counsel; and
      3. (iii) Call witnesses.

   2. (B) The department may:

      1. (i) Appear by such officials as the division may deem necessary;
      2. (ii) Be represented by counsel; and
      3. (iii) Call witnesses.

2. (2)

   1. (A) All testimony shall be under oath.

   2. (B) Each party shall have the right to:

      1. (i) Call and examine parties and witnesses;
      2. (ii) Introduce exhibits;
      3. (iii) Question opposing witnesses and parties on any matter relevant to the issue; and
      4. (iv) Rebut opposing evidence.
   3. (C) The appellant shall have the burden of proving whatever facts it must establish to sustain its position by a preponderance of the evidence.

3. (3) The hearing officer shall conduct himself or herself in an impartial manner, and may question any party or witness at any time during the hearing.

   1. (c) Decisions.
4. (1) All decisions rendered shall be submitted by the hearing officer in writing to the secretary for his or her review and final determination.
5. (2) At his or her discretion and for good cause, the secretary shall have the right to reverse a decision or to return the issue to the hearing officer for further consideration or additional findings of law or fact.
6. (3) All decisions by the hearing officer and the secretary shall contain findings of fact and law in accordance with applicable state and federal laws, rules, and regulations.

7. (4) The final decision shall be rendered in writing to the appellant.

   1. (d) Mediation process.

8. (1)

   1. (A) If a long-term care facility in its written notice of appeal states it desires to utilize the mediation process in an attempt to resolve the dispute or disputes between the facility and the department, as stated in the notice of appeal, and the department agrees to the mediation process, then mediation shall be utilized to clarify, narrow, or resolve the dispute or disputes.
   2. (B) The department shall maintain a list of mediators supplied by the Arkansas Alternative Dispute Resolution Commission.
   3. (C) The objective of the mediation process is to help each side in the dispute or disputes understand the other’s point of view, with a goal of narrowing, clarifying, or resolving issues in dispute.
   4. (D) If the dispute is or disputes are resolved as a result of mediation, then a written statement signed by both parties will be filed with the secretary or his or her designee, shall substitute for a decision in the case, and shall not be appealable.

9. (2)

   1. (A) The Office of Chief Counsel of the Department of Human Services shall submit a list of available mediators from which a mediator agreed to by both parties will be selected.

   2. (B)

      1. (i) The mediator shall restrict his or her discussions to the designated representatives of the appealing facility and the designated representative of the department.
      2. (ii) Designated representatives include each party’s attorneys.
   3. (C) The mediation shall not bind the parties.
   4. (D) The mediation shall not add anything to the record except a final written agreement.
   5. (E) The parties may add to the record, but only to the extent they both agree.
   6. (F) The mediation shall not unduly delay the process of a case.
   7. (G) Time limits for appointing a hearing officer and a decision shall be temporarily suspended during the mediation.
   8. (H) The mediator shall ensure the parties are continuing to work towards resolution of the dispute.
   9. (I) The negotiations shall be confidential and shall not be communicated to any decision makers who may serve as future hearing officers.
   10. (J) If the mediation fails to produce an agreement or if mediation is not proceeding toward resolving the dispute, then the mediator or either party may so notify the secretary or his or her designee.
   11. (K) The secretary or his or her designee will terminate the mediation whereupon the appeal will proceed as outlined in this section.
10. (3) The appealing facility and the department shall equally share the cost of the mediator’s fee.