1. (1)(a) If a provider requests review of an agency action initiated by the office, the matter shall be set for a settlement conference between the parties.

   1. (b) The purpose of the settlement conference is to give the parties an opportunity to discuss the issues in the case and attempt to resolve the matter without a hearing.
2. (2) If the parties are able to resolve the matter, the office shall memorialize the resolution reached in writing and send a copy to the provider.

3. (3)(a) If after negotiation, the parties are unable to resolve the matter, a party may request the matter be set for a prehearing conference with the ALJ.

   1. (b) The purpose of the prehearing with the ALJ is to set the matter for hearing.
4. (4) A party may be represented by counsel in the agency review process and at a hearing.

KEY: Office of the Inspector General of Medicaid Services, adjudicative procedures

Date of Last Change: June 1, 2018

Notice of Continuation: May 17, 2023

Authorizing, and Implemented or Interpreted Law: 63A-13; 63G-4