Hearings granted applicants and suppliers of services, when--classaction authorized for suppliers, requirements--claims may becumulative--procedure--appeal.
208.156. 1. The division of family services shall providefor granting an opportunity for a fair hearing under section208.080 to any applicant or recipient whose claim for medicalassistance is denied or is not acted upon with reasonablepromptness.
2. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 whose claim for reimbursement for such services is deniedor is not acted upon with reasonable promptness shall be entitledto a hearing before the administrative hearing commissionpursuant to the provisions of chapter 621, RSMo.
3. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is denied participation in any program or programsestablished under the provisions of chapter 208 shall be entitledto a hearing before the administrative hearing commissionpursuant to the provisions of chapter 621, RSMo.
4. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is aggrieved by any rule or regulation promulgated bythe department of social services or any division therein shallbe entitled to a hearing before the administrative hearingcommission pursuant to the provisions of chapter 621, RSMo.
5. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is aggrieved by any rule or regulation, contractualagreement, or decision, as provided for in section 208.166, bythe department of social services or any division therein shallbe entitled to a hearing before the administrative hearingcommission pursuant to the provisions of chapter 621, RSMo.
6. No provider of service may file a petition for a hearingbefore the administrative hearing commission unless the amountfor which he seeks reimbursement exceeds five hundred dollars.
7. One or more providers of service as will fairly insureadequate representation of others having similar claims againstthe department of social services or any division therein mayinstitute the hearing on behalf of all in the class if there is acommon question of law or fact affecting the several rights and acommon relief is sought.
8. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 and who is entitled to a hearing as provided for in thepreceding sections shall have thirty days from the date ofmailing or delivery of a decision of the department of socialservices or its designated division in which to file his* petitionfor review with the administrative hearing commission except thatclaims of less than five hundred dollars may be accumulated untilthey total that sum and at which time the provider shall haveninety days to file his** petition.
9. When a person entitled to a hearing as provided for inthis section applies to the administrative hearing commission fora stay order staying the actions of the department of socialservices or its divisions, the administrative hearing commissionshall not grant such stay order until after a full hearing onsuch application. The application shall be advanced on thedocket for immediate hearing and determination. The personapplying for such stay order shall not be granted such stay orderunless that person shall show that immediate and irreparableinjury, loss, or damage will result if such stay order is denied,or that such person has a reasonable likelihood of success uponthe merits of his** claim; and provided further that no stay ordershall be issued without the person seeking such order posting abond in such sum as the administrative hearing commission findssufficient to protect and preserve the interest of the departmentof social services or its divisions. In no event may theadministrative hearing commission grant such stay order where theclaim arises under a program or programs funded by federal fundsor by any combination of state and federal funds, unless it isspecified in writing by the financial section of the appropriatefederal agency that federal financial participation will becontinued under the stay order.
10. The other provisions of this section notwithstanding, aperson receiving or providing benefits shall have the right tobring an action in appealing from the administrative hearingcommission in the circuit court of Cole County, Missouri, or thecounty of his residence pursuant to section 536.050, RSMo.
(1993) Where action is based on specific facts involving named entities and is a challenge to an agency decision, jurisdiction to challenge decision is vested in the administrative hearing commission under this section. Because action challenged an agency decision and not an agency rule, section 536.050, RSMo, does not allow a declaratory judgment action to be brought in the circuit court. Missouri Health Care Association, EBG III, Inc. v. Missouri Department of Social Services, 851 S.W.2d 567 (Mo.App.W.D.).
Hearings granted applicants and suppliers of services, when--classaction authorized for suppliers, requirements--claims may becumulative--procedure--appeal.
208.156. 1. The division of family services shall providefor granting an opportunity for a fair hearing under section208.080 to any applicant or recipient whose claim for medicalassistance is denied or is not acted upon with reasonablepromptness.
2. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 whose claim for reimbursement for such services is deniedor is not acted upon with reasonable promptness shall be entitledto a hearing before the administrative hearing commissionpursuant to the provisions of chapter 621, RSMo.
3. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is denied participation in any program or programsestablished under the provisions of chapter 208 shall be entitledto a hearing before the administrative hearing commissionpursuant to the provisions of chapter 621, RSMo.
4. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is aggrieved by any rule or regulation promulgated bythe department of social services or any division therein shallbe entitled to a hearing before the administrative hearingcommission pursuant to the provisions of chapter 621, RSMo.
5. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is aggrieved by any rule or regulation, contractualagreement, or decision, as provided for in section 208.166, bythe department of social services or any division therein shallbe entitled to a hearing before the administrative hearingcommission pursuant to the provisions of chapter 621, RSMo.
6. No provider of service may file a petition for a hearingbefore the administrative hearing commission unless the amountfor which he seeks reimbursement exceeds five hundred dollars.
7. One or more providers of service as will fairly insureadequate representation of others having similar claims againstthe department of social services or any division therein mayinstitute the hearing on behalf of all in the class if there is acommon question of law or fact affecting the several rights and acommon relief is sought.
8. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 and who is entitled to a hearing as provided for in thepreceding sections shall have thirty days from the date ofmailing or delivery of a decision of the department of socialservices or its designated division in which to file his* petitionfor review with the administrative hearing commission except thatclaims of less than five hundred dollars may be accumulated untilthey total that sum and at which time the provider shall haveninety days to file his** petition.
9. When a person entitled to a hearing as provided for inthis section applies to the administrative hearing commission fora stay order staying the actions of the department of socialservices or its divisions, the administrative hearing commissionshall not grant such stay order until after a full hearing onsuch application. The application shall be advanced on thedocket for immediate hearing and determination. The personapplying for such stay order shall not be granted such stay orderunless that person shall show that immediate and irreparableinjury, loss, or damage will result if such stay order is denied,or that such person has a reasonable likelihood of success uponthe merits of his** claim; and provided further that no stay ordershall be issued without the person seeking such order posting abond in such sum as the administrative hearing commission findssufficient to protect and preserve the interest of the departmentof social services or its divisions. In no event may theadministrative hearing commission grant such stay order where theclaim arises under a program or programs funded by federal fundsor by any combination of state and federal funds, unless it isspecified in writing by the financial section of the appropriatefederal agency that federal financial participation will becontinued under the stay order.
10. The other provisions of this section notwithstanding, aperson receiving or providing benefits shall have the right tobring an action in appealing from the administrative hearingcommission in the circuit court of Cole County, Missouri, or thecounty of his residence pursuant to section 536.050, RSMo.
(1993) Where action is based on specific facts involving named entities and is a challenge to an agency decision, jurisdiction to challenge decision is vested in the administrative hearing commission under this section. Because action challenged an agency decision and not an agency rule, section 536.050, RSMo, does not allow a declaratory judgment action to be brought in the circuit court. Missouri Health Care Association, EBG III, Inc. v. Missouri Department of Social Services, 851 S.W.2d 567 (Mo.App.W.D.).
Hearings granted applicants and suppliers of services, when--classaction authorized for suppliers, requirements--claims may becumulative--procedure--appeal.
208.156. 1. The division of family services shall providefor granting an opportunity for a fair hearing under section208.080 to any applicant or recipient whose claim for medicalassistance is denied or is not acted upon with reasonablepromptness.
2. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 whose claim for reimbursement for such services is deniedor is not acted upon with reasonable promptness shall be entitledto a hearing before the administrative hearing commissionpursuant to the provisions of chapter 621, RSMo.
3. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is denied participation in any program or programsestablished under the provisions of chapter 208 shall be entitledto a hearing before the administrative hearing commissionpursuant to the provisions of chapter 621, RSMo.
4. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is aggrieved by any rule or regulation promulgated bythe department of social services or any division therein shallbe entitled to a hearing before the administrative hearingcommission pursuant to the provisions of chapter 621, RSMo.
5. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 who is aggrieved by any rule or regulation, contractualagreement, or decision, as provided for in section 208.166, bythe department of social services or any division therein shallbe entitled to a hearing before the administrative hearingcommission pursuant to the provisions of chapter 621, RSMo.
6. No provider of service may file a petition for a hearingbefore the administrative hearing commission unless the amountfor which he seeks reimbursement exceeds five hundred dollars.
7. One or more providers of service as will fairly insureadequate representation of others having similar claims againstthe department of social services or any division therein mayinstitute the hearing on behalf of all in the class if there is acommon question of law or fact affecting the several rights and acommon relief is sought.
8. Any person authorized under section 208.153 to provideservices for which benefit payments are authorized under section208.152 and who is entitled to a hearing as provided for in thepreceding sections shall have thirty days from the date ofmailing or delivery of a decision of the department of socialservices or its designated division in which to file his* petitionfor review with the administrative hearing commission except thatclaims of less than five hundred dollars may be accumulated untilthey total that sum and at which time the provider shall haveninety days to file his** petition.
9. When a person entitled to a hearing as provided for inthis section applies to the administrative hearing commission fora stay order staying the actions of the department of socialservices or its divisions, the administrative hearing commissionshall not grant such stay order until after a full hearing onsuch application. The application shall be advanced on thedocket for immediate hearing and determination. The personapplying for such stay order shall not be granted such stay orderunless that person shall show that immediate and irreparableinjury, loss, or damage will result if such stay order is denied,or that such person has a reasonable likelihood of success uponthe merits of his** claim; and provided further that no stay ordershall be issued without the person seeking such order posting abond in such sum as the administrative hearing commission findssufficient to protect and preserve the interest of the departmentof social services or its divisions. In no event may theadministrative hearing commission grant such stay order where theclaim arises under a program or programs funded by federal fundsor by any combination of state and federal funds, unless it isspecified in writing by the financial section of the appropriatefederal agency that federal financial participation will becontinued under the stay order.
10. The other provisions of this section notwithstanding, aperson receiving or providing benefits shall have the right tobring an action in appealing from the administrative hearingcommission in the circuit court of Cole County, Missouri, or thecounty of his residence pursuant to section 536.050, RSMo.
(1993) Where action is based on specific facts involving named entities and is a challenge to an agency decision, jurisdiction to challenge decision is vested in the administrative hearing commission under this section. Because action challenged an agency decision and not an agency rule, section 536.050, RSMo, does not allow a declaratory judgment action to be brought in the circuit court. Missouri Health Care Association, EBG III, Inc. v. Missouri Department of Social Services, 851 S.W.2d 567 (Mo.App.W.D.).
