115 C.M.R. 8.07 – Administrative Reconsideration

(1) Within ten working days after receipt of the final provider report, the provider may file a written request for an administrative reconsideration with the regional quality enhancement director in all cases except with respect to a decision of non-licensure. Decisions of revocation or denial of licensure are subject to a separate review and appeal through 115 CMR 8.08 and are not subject to administrative reconsideration.
(2) The basis for a request for administrative reconsideration shall be disagreement with:
1. (a) the facts or the conclusions in the provider report;
2. (b) the timelines for follow-up; and/or
3. (c) correction of the areas needing improvement.
(3) Administrative reconsideration may not be requested on the basis of provider disagreement with:
1. (a) the content of the survey tool;
2. (b) the composition of the team;
3. (c) the methodology developed for scoring the survey.
(4) Within 30 days of the receipt of the request for reconsideration, the regional quality enhancement director shall render a written decision that shall state its conclusions and rationale.
(5) Within ten working days of receipt of the written decision from the regional quality enhancement director, the provider may file a written request for a second level of administrative reconsideration which is available only to challenge the standards applied and/or procedure followed in the first level of administrative reconsideration.
(6) The second level administrative reconsideration shall be conducted by the director of licensure and certification or designee who shall render a decision within 30 days of receipt of the request. The decision rendered at the second level of administrative reconsideration is final and not subject to further review.