State Fair Hearings Sample Clauses

State Fair Hearings. ‌ (a) AHS shall alone be responsible for developing and implementing State Fair Hearing rules and policies. (b) AHS shall be responsible for ensuring that State Fair Hearing rules, policies, and practices comply with the federal statutes and regulations, including provisions applicable to DVHA operations. (c) In most cases, the beneficiaries must exhaust the internal appeal prior to making a State Fair Hearing request, unless exhaustion is deemed as set forth above in Section 2.18(b)(iii). A beneficiary who seeks review of a service not subject to the internal appeal process pursuant to HCAE 8.100.1 does not have to exhaust the internal appeal process. (d) Beneficiaries have the right to file requests for State Fair Hearing related to eligibility and premium determinations. With the written consent of the beneficiary, a provider or an authorized representative may request a State Fair Hearing on behalf of the beneficiary. The beneficiary, his/her representative, or the representative of a deceased beneficiary’s estate shall be parties to a State Fair Hearing. (e) AHS shall retain responsibility for representing the State in any fair hearings pertaining to such eligibility and premium determinations. Hearing descriptions must be included in beneficiary and provider information within the contract. (f) AHS will accept a timely request for a State Fair Hearing from a beneficiary and will process the request without delay. A timely request for a State fair hearing (g) Beneficiaries also have the right to file a request for an expedited State Fair Hearing after exhausting the internal appeal process for expedited appeals, unless exhaustion is deemed as set forth above in Section 2.18(b)(iii). (h) Expedited State Fair Hearing shall be resolved as expeditiously as the beneficiary’s health condition requires, but no later than 3 working days after the agency (the Human Services Board) received the case record and information for an appeal that AHS indicates meets the standard for an expedited appeal. When the matter is not expedited (i.e., standard resolution), the final administrative decision must be sent to the beneficiary within 90 days from the date the beneficiary filed the internal appeal, not counting the number of days the beneficiary took to subsequently file for a State Fair Hearing.
Sample 1
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State Fair Hearings. 1. To advise Enrollees that they may request a State fair hearing within 120 days of an MCO appeal resolution using the process specified in COMAR 10.01.04. 2. To be a party to any State fair hearing before the Office of Administrative Hearings held as a result of an enrollee’s appeal, along with the Enrollee, the Enrollee’s representative (if applicable), or the personal representative of a deceased Enrollee’s estate (if applicable). 3. To provide documentation regarding medical determinations to Enrollees and the Office of Administrative Hearings as required by COMAR 10.01.04 and other applicable law. 4. To continue the Enrollee’s benefits pending the outcome of the State fair hearing if all of the following occur: a. The Enrollee files for continuation of benefits within 10 days of the MCO upholding its action; b. The State fair hearing request is filed timely, meaning on or before the later of the following: a. Within 10 days of the date on the MCO’s notice of appeal resolution; or b. The intended effective date of the MCO's proposed action; c. The State fair hearing involves the termination, suspension, or reduction of a previously authorized service; and d. The services were ordered by an authorized provider. 5. To continue or reinstate the Enrollee's benefits while the State fair hearing is pending until one of the following occurs: a. The Enrollee withdraws the State fair hearing; or b. A State fair hearing decision adverse to the Enrollee is issued by the Office of Administrative Hearings.
Sample 1
State Fair Hearings. 13.1.4.1 The Contractor shall participate in State Fair Hearings as directed by EOHHS. Hearing shall be conducted in accordance with guidelines, rules, and regulations established by the State’s Administrative Procedures act and 42 C.F.R. Subpart E – Fair Hearings for Applicants and Beneficiaries. 13.1.4.2 The Contractor shall attend and prepare documentation for State Fair Hearings and related meetings.
Sample 1
State Fair Hearings 
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Related to State Fair Hearings

  • Public Hearings If public hearings on the scope of work are held during the period of the Agreement, Contractor will make available to testify the personnel assigned to this Agreement. The Energy Commission will reimburse Contractor for compensation and travel of the personnel at the Agreement rates for the testimony which the Energy Commission requests.

  • Public Hearing In the course of each proceeding, the competent investigating authority shall:

  • Meetings and Hearings All meetings and hearings under this procedure shall not be conducted in public and shall include only such parties in interest and their designated or selected representatives, heretofore referred to in this Article.

  • Compliance with Federal and State Work Authorization and Immigration Laws The Contractor and all subcontractors, suppliers and consultants must comply with all federal and state work authorization and immigration laws, and must certify compliance using the form set forth in Section 7 (“Georgia Security and Immigration Compliance Act Affidavits”). The required certificates must be filed with the Owner and copied maintained by the Contractor as of the beginning date of this contract and each subcontract, supplier contract, or consultant contract, and upon final payment to the subcontractor or consultant. State officials, including officials of the Georgia Department of Audits and Accounts, officials of the Owner, retain the right to inspect and audit the Project Site and employment records of the Contractor, subcontractors and consultants without notice during normal working hours until Final Completion, and as otherwise specified by law and by Rules and Regulations of the Georgia Department of Audits and Accounts.

  • Compliance with Federal Law, Regulations, and Executive Orders This is an acknowledgement that FEMA financial assistance will be used to fund all or a portion of the contract. The contractor will comply with all applicable Federal law, regulations, executive orders, FEMA policies, procedures, and directives.

  • Civil Actions Except where there has been gross negligence on the part of an employee, the Employer will: (1) exempt and save harmless employees from any liability action arising from the proper performance of their duties for the Employer; and (2) assume all costs, legal fees, and other expenses arising from any such action.

  • Hearings The Hearing Officer shall hold hearings on a quarterly basis unless there are no appeals to hear or the parties agree to pend any open appeals. All materials considered in the position review shall be submitted to the Hearing Officer prior to the hearing and neither party will submit evidence at the hearing that was not submitted during the position review. The Hearing Officer shall endeavor to hold multiple hearings each day, and shall issue a concise decision which shall be final and binding. The Hearing Officer shall have no authority to alter the terms and conditions of this contract. Employees may be represented at the hearing and will be released from work with no loss of pay to attend the hearing. The Hearing Officer's fees and expenses shall be shared equally by the parties.

  • Contractor Hearing Board 1. If there is evidence that the Contractor may be subject to debarment, the Department will notify the Contractor in writing of the evidence which is the basis for the proposed debarment and will advise the Contractor of the scheduled date for a debarment hearing before the Contractor Hearing Board. 2. The Contractor Hearing Board will conduct a hearing where evidence on the proposed debarment is presented. The Contractor and/or the Contractor’s representative shall be given an opportunity to submit evidence at that hearing. After the hearing, the Contractor Hearing Board shall prepare a tentative proposed decision, which shall contain a recommendation regarding whether the Contractor should be debarred, and, if so, the appropriate length of time of the debarment. The Contractor and the Department shall be provided an opportunity to object to the tentative proposed decision prior to its presentation to the Board of Supervisors. 3. After consideration of any objections, or if no objections are submitted, a record of the hearing, the proposed decision, and any other recommendation of the Contractor Hearing Board shall be presented to the Board of Supervisors. The Board of Supervisors shall have the right to modify, deny, or adopt the proposed decision and recommendation of the Contractor Hearing Board. 4. If a Contractor has been debarred for a period longer than five (5) years, that Contractor may after the debarment has been in effect for at least five (5) years, submit a written request for review of the debarment determination to reduce the period of debarment or terminate the debarment. The County may, in its discretion, reduce the period of debarment or terminate the debarment if it finds that the Contractor has adequately demonstrated one or more of the following: (1) elimination of the grounds for which the debarment was imposed; (2) a bona fide change in ownership or management; (3) material evidence discovered after debarment was imposed; or (4) any other reason that is in the best interests of the County. 5. The Contractor Hearing Board will consider a request for review of a debarment determination only where (1) the Contractor has been debarred for a period longer than five (5) years; (2) the debarment has been in effect for at least five (5) years; and (3) the request is in writing, states one or more of the grounds for reduction of the debarment period or termination of the debarment, and includes supporting documentation. Upon receiving an appropriate request, the Contractor Hearing Board will provide notice of the hearing on the request. At the hearing, the Contractor Hearing Board shall conduct a hearing where evidence on the proposed reduction of debarment period or termination of debarment is presented. This hearing shall be conducted and the request for review decided by the Contractor Hearing Board pursuant to the same procedures as for a debarment hearing. 6. The Contractor Hearing Board’s proposed decision shall contain a recommendation on the request to reduce the period of debarment or terminate the debarment. The Contractor Hearing Board shall present its proposed decision and recommendation to the Board of Supervisors. The Board of Supervisors shall have the right to modify, deny, or adopt the proposed decision and recommendation of the Contractor Hearing Board.

  • Court Appearance Leave Leave shall be granted for appearance before a court, legislative committee, or other judicial or quasi-judicial body in response to a subpoena, or other direction of proper authority, for job related purposes other than those instituted by the employee or the exclusive representative. Leave shall also be granted for attendance in court in connection with an employee's official duty, which shall include any necessary travel time. Such employee shall be paid for the employee's regular pay less the fee received, exclusive of expenses, for serving as a witness, as required by the court.

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