(a)
- (1) If the Department of Human Services denies, suspends, or revokes any behavioral health agency certification (takes adverse action), the affected proposed provider or providers may appeal the department adverse action.
- (2) Notice of adverse action shall comply with Arkansas Code §§ 20-77-1701 – 20-77-1705, and Arkansas Code §§ 20-77-1708 – 20-77-1713.
- (3) Appeals must be submitted in writing to the department.
- (4) The provider has thirty (30) calendar days from the date of the notice of adverse action to appeal.
- (5) An appeal request received within thirty-five (35) calendar days of the date of the notice will be deemed timely.
- (6) The appeal must state with particularity the error or errors asserted to have been made by the department in denying certification, and cite the legal authority for each assertion of error.
- (7) The provider may elect to continue Medicaid billing under the behavioral health agency program during the appeals process.
- (8) If the appeal is denied, the provider must return all moneys received for behavioral health agency services provided during the appeals process.
(b) Within thirty (30) calendar days after receiving an appeal, the department shall:
- (1) Designate a person who did not participate in reviewing the application or in the appealed-from adverse decision to hear the appeal;
- (2) Set a date for the appeal hearing; and
(3)
- (A) Notify the appellant in writing of the date, time, and place of the hearing.
- (B) The hearing shall be set within sixty (60) calendar days of the date the department receives the request for appeal, unless a party to the appeal requests and receives a continuance for good cause.
- (c) The department shall tape record each hearing.
(d)
- (1) The hearing official shall issue the decision within forty-five (45) calendar days of the date that the hearing record is completed and closed.
(2) The hearing official shall issue the decision in a written document that contains:
- (A) Findings of fact;
- (B) Conclusions of law; and
- (C) The decision.
- (3) The findings, conclusions, and decision shall be mailed to the appellant except that if the appellant is represented by counsel, a copy of the findings, conclusions, and decision shall also be mailed to the appellant’s counsel.
- (4) The decision is the final agency determination under the Arkansas Administrative Procedure Act, Arkansas Code § 25-15-201 et seq.
(e)
- (1) Delays caused by the appealing party shall not count against any deadline.
- (2) Failure to issue a decision within the time required is not a decision on the merits and shall not alter the rights or status of any party to the appeal, except that any party may pursue legal process to compel the hearing official to render a decision.
- (f) Except to the extent that they are inconsistent with this policy, the appeal procedures in the Medicaid Outpatient Behavioral Health Services Manual are incorporated by reference and shall control.