OAR 418-040-0090
Provider Termination and Hearing Rights
(1)
The Commission delegates authority to the Executive Director of the Oregon Home Care Commission to act on behalf of the Commission for the purposes of making decisions related to a provider’s eligibility to provide services under the Homecare Choice Program. This includes:(a)
Provider enrollment;(b)
Denial or revocation of provider enrollment; and(c)
Provider sanctions, which may include, suspension of Registry referrals.(2)
When a Homecare Choice provider is terminated based on violations described in OAR 418-040-0040 (Provider Qualifications)(1)(c)(A) - (L), the Commission shall issue a written notice to the provider.(a)
The written notice must include:(A)
The effective date of the termination.(B)
An explanation of the reason for terminating the provider enrollment.(C)
The alleged violation as listed in OAR 418-040-0040 (Provider Qualifications)(1)(c)(A)–(L).(D)
The provider’s right to a contested case hearing and where to file the hearing request.(b)
For terminations based on substantiated protective services allegations, the notice may only contain the information allowed by law. In accordance with ORS 124.075 (Immunity of person making report in good faith), 124.085 (Catalog of abuse records), 124.090 (Confidentiality of records), OAR 407-045-0330 (Adult Developmental Disabilities Abuse Rules: Disclosure of the Abuse Investigation and Protective Services Report and Related Documents), 411-020-0030 (Confidentiality), 413-015-0485 (Confidentiality), and 943-045-0330 (Disclosure of the Abuse or Mistreatment Investigation and Protective Services Report and Related Documents), complainants, witnesses, the name of the alleged victim, and protected health information may not be disclosed.(3)
BURDEN OF PROOF. The Commission has the burden of proving the allegations of the complaint by a preponderance of the evidence. Evidence submitted for the administrative hearing is governed by OAR 137-003-0610 (Evidentiary Rules).(4)
IMMEDIATE TERMINATION. The Commission may immediately terminate a provider’s enrollment on the date the violation is discovered, before the outcome of the administrative review, when an alleged violation presents imminent danger to current or future participants. In order for a provider’s hearing request to be timely, any hearing request must be filed with the Commission within 10 business days from the date of the notice.(5)
TERMINATIONS PENDING APPEAL. When a violation does not present imminent danger to current or future participants, the provider’s enrollment may not be terminated during the first 10 business days after the termination notice. In order for a provider’s hearing request to be timely, any hearing request must be filed with the Commission within 10 business days from the date of the notice. If the provider appeals in writing before the deadline for the appeal, the enrollment may not be terminated until the conclusion of the contested case proceeding.(6)
TERMINATION IF NO APPEAL FILED. The decision of the Commission’s Executive Director becomes final if the Homecare Choice provider does not appeal within 10 business days from the date of the notice of the decision.(7)
CONTESTED CASE PROCESS. A Homecare Choice provider may request an administrative hearing after the conclusion of the administrative review process if the provider continues to dispute the decision to terminate his or her enrollment in the Homecare Choice Program.(a)
A request for hearing must be filed with the Commission within 10 business days of the date of the written notice from the Commission.(b)
When the Commission or the Department refers a contested case under these rules to the Office of Administrative Hearings, the referral will indicate whether the Commission is authorizing a proposed order, a proposed and final order, or a final order.(c)
Subject to approval of the Attorney General, an officer or employee of the Department or the Commission, is authorized to appear on behalf of the Commission for hearings conducted by the Office of Administrative Hearings related to provider enrollment, denial, or revocation of provider enrollment, and provider sanctions. Contested case hearings and the use of lay representation in contested case hearings related to this rule shall be in accordance with OAR chapter 411, division 001.(d)
No additional hearing rights have been granted to Homecare Choice providers by this rule other than the right to a hearing on the Commission’s decision to terminate the individual’s provider enrollment.
Source:
Rule 418-040-0090 — Provider Termination and Hearing Rights, https://secure.sos.state.or.us/oard/view.action?ruleNumber=418-040-0090.