Rules and Regulations of the State of Georgia
 

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  • 1. In the address bar, type about:config and press Enter.
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target="_blank"><em class="mnemonic">S</em>earch tips</a></div><ul class="breadcrumb"> <li><a href="/GAC" name="GAC" title="GAC">GA R&amp;R</a></li> <li>&raquo; <a href="/GAC/350" title="350">Department 350</a></li> <li>&raquo; Chapter 350-4</li> </ul> </div> </div><div id="doc" class="container"> <div id="doc-content" class="content"> <h1><nllchapter>Chapter 350-4 ADMINISTRATIVE REVIEW, HEARINGS AND APPEALS</nllchapter></h1> <h2><a href="/GAC/350-4-.01" name="350-4-.01" title="350-4-.01">Rule 350-4-.01 Hearings Conducted by the Department of Medical Assistance</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.01(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An Administrative Law Judge appointed by the Department shall conduct provider hearings with respect to the following cases: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.01(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a provider is aggrieved by an action of the Department with respect to a denial of, or the determination of the amount of, medical assistance paid on a certain item of medical or remedial care or service rendered by such provider;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.01(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a provider of medical assistance is aggrieved by an action of the Department with respect to the Department's determination of the provider's billing rate or reimbursement rate for a particular fiscal year;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.01(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a person or institution either has been refused enrollment as a provider in the State Plan or has been suspended or terminated as a provider by the Department for any reason other than want of any license, permit, certificate, approval, registration, charter, or other form of permission issued by an entity other than the Department, which form of permission is required by law either to render care or to receive medical assistance in which federal financial participation is available;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.01(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a provider is aggrieved by any adverse action specified in these Rules, except as provided in Chapter 350-3, or a Policies and Procedures Manual published by the Department.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.01(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All such hearings shall be conducted in accordance with the rules contained in this Chapter.</td> </tr> </table> <h2><a href="/GAC/350-4-.02" name="350-4-.02" title="350-4-.02">Rule 350-4-.02 Hearings Conducted by the Department of Human Resources</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Hearings shall be conducted by the Department of Human Resources in the following cases: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a recipient of medical assistance is aggrieved by the action or inaction of the Department as to any medical or remedial care or service which such recipient alleges should be reimbursed under the terms of the Georgia State Plan for Medical Assistance which was in effect on the date on which such care or service was rendered or is sought to be rendered;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when an application for medical assistance is denied or is not acted upon with reasonable promptness;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a recipient or applicant has been aggrieved by an action or inaction of the Department or its agent with respect to a determination of the level of care status applicable to that person;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when individuals are adversely affected by determinations made during the pre-admission screening or post-admission resident review required by Social Security Act °1919(e)(7), as amended, as implemented by Section 4211 of the Omnibus Budget Reconciliation Act of 1987;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when an institution has received notice that it will be: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(e)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> decertified to participate under the State Plan for Medical Assistance,</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(e)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> denied a license to operate a nursing facility, or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(e)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> refused enrollment as a provider in the State Plan or terminated as a provider based on the want of any license, permit, certificate, approval, registration, charter or other form of permission issued by the Department of Human Resources;</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a hearing is obtained pursuant to the provisions of Chapter 350-3 of these Rules; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(1)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when a recipient or applicant has been aggrieved by an action of the Department or its agent with respect to collection of funds paid in behalf of the recipient for medical services.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.02(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All hearings pursuant to this section will be conducted under the Rules of the Department of Human Resources.</td> </tr> </table> <h2><a href="/GAC/350-4-.03" name="350-4-.03" title="350-4-.03">Rule 350-4-.03 Right to Representation</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.03(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Providers may represent themselves, or may choose to be represented by legal counsel or any other spokesperson. However, providers may not be represented by employees or agents of the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.03(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An Administrative Law Judge may exclude from the hearing any person who: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.03(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> engages in unethical, disruptive, or contemptuous conduct;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.03(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> intentionally fails to comply with the proper instructions or orders of the Administrative Law Judge or the provisions of these Rules; and/or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.03(2)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> represents more than one party, in violation of any applicable authority regarding conflicts of interest.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.03(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When a provider is represented by another person, all notices issued in the course of the administrative appeals process which would otherwise go to the provider shall be sent to the provider's representative instead.</td> </tr> </table> <h2><a href="/GAC/350-4-.04" name="350-4-.04" title="350-4-.04">Rule 350-4-.04 Administrative Review</a></h2> <P>The Department shall offer the opportunity for Administrative Review to any provider against whom it proposes to take an adverse action unless the Department is otherwise authorized by law to take such action without opportunity for appeal by the provider prior to the action's implementation. The procedures and deadlines for obtaining such Administrative Review and the deadlines for decisions thereon shall be published in the Policies and Procedures Manual for each service category to which they apply. Administrative Review shall be completed, if not waived by the provider, prior to implementation of the proposed action. Whenever the opportunity for Administrative Review is available to the provider, such Administrative Review must be timely obtained and completed for the provider to be entitled to a hearing.</P> <h2><a href="/GAC/350-4-.05" name="350-4-.05" title="350-4-.05">Rule 350-4-.05 Hearing Requests</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A request for a hearing must be in writing and received by the Department: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> within ten (10) days after the date on which a notice of denial of a request for enrollment or notice of suspension or termination was transmitted to the provider; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> concerning any other action or inaction by the Department which aggrieves the provider, within ten (10) days after the date of the later of: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(1)(b)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> the Department's action for which the hearing is sought, if no opportunity for Administrative Review was available, or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(1)(b)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> notice of the final decision of the entity to which request for Administrative Review has been addressed.<P>In determining the timeliness of a request, the Department will compute the number of days in accordance with Rule <a title="350-1-.01(24)" href="350-1-.01#350-1-.01(24)">350-1-.01(24)</a>, if the date of the provider's receipt of notice of the adverse action being appealed is known to the Department; if the date of receipt by the provider is not known, the Department shall add five (5) days from the date of transmission of the notice to allow for delivery. Nothing herein shall bar proof of actual date of receipt by the provider or its agent, subject to the provisions of subsection 19.</P> </td> </tr> </table> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The request for a hearing must include all of the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> a clear expression by the provider or an authorized representative that the provider wishes to present a case to an Administrative Law Judge;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> identification of the adverse administrative review decision or other Department action being appealed and, if only part of such decision or action aggrieves the provider, the specific part which the provider will address at the hearing;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(2)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> a specific statement of why the provider believes the administrative review decision or other Department action is wrong; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(2)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> a statement of the relief sought.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If any of the requirements listed in Paragraph (2) have not been met, the Department shall so notify the provider. Thereafter, the Department must receive a corrected request within ten (10) days of the provider's receipt of the deficiency notice or the request shall be deemed untimely.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Requests for hearings shall be denied if the Department determines that: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(4)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the request was not timely filed;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(4)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the action or inaction appealed by the provider is solely the result of a change in state or federal law;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(4)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the issues raised by the provider fall outside the jurisdiction of the administrative hearing process; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.05(4)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the requesting party has not been aggrieved.<P>If there is a <I>bona fide</I> question of fact concerning any of the items described in this Subsection 4, and the provider establishes such question of fact by sworn affidavit within a reasonable time set by the Office of Special Services and made known in writing to the provider, the Department shall grant a hearing and defer these questions for final determination by the Administrative Law Judge.</P> </td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/350-4-.06" name="350-4-.06" title="350-4-.06">Rule 350-4-.06 Dismissal of Hearing Requests</a></h2> <P>The Administrative Law Judge may dismiss a request for a hearing for the following reasons:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> it has been withdrawn by the provider in writing;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> there is no genuine issue of law or fact which requires a hearing determination;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the provider without good cause therefor fails to appear in person by an authorized representative at the scheduled hearing, or the Administrative Law Judge determines that the provider's failure to comply with his directives or orders constitutes an abandonment of the request;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> there is a lack of jurisdiction over the subject matter or the parties;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the party requesting the hearing has not been aggrieved;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the parties have settled the matter prior to issuance of the Administrative Law Judge's decision;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.06(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> at the request of any party or on his own motion, the Administrative Law Judge determines that the requesting party has not met the prerequisites for obtaining a hearing, the case is not ripe for an Administrative Law Judge's determination, or the case has been rendered moot.</td> </tr> </table> <h2><a href="/GAC/350-4-.07" name="350-4-.07" title="350-4-.07">Rule 350-4-.07 Informal Disposition; Settlement</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.07(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Informal disposition may be made of any contested case by stipulation, written agreement, or consent order.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.07(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The parties may agree to settle the matters in dispute at any time prior to the issuance of the Administrative Law Judge's decision, whereupon the Administrative Law Judge shall dismiss the matter forthwith.</td> </tr> </table> <h2><a href="/GAC/350-4-.08" name="350-4-.08" title="350-4-.08">Rule 350-4-.08 The Administrative Law Judge</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each request for hearing meeting the specifications of Section <a title="350-4-.06" href="350-4-.06">350-4-.06</a> shall be transmitted to an Administrative Law Judge appointed under authority of the Commissioner to adjudicate the matter in dispute.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge shall be a competent, qualified, and impartial individual who has not been involved in the action which has given rise to the hearing request. The Administrative Law Judge shall be an attorney who has a working knowledge of the Georgia Medicaid program and/or administrative law and the ability to conduct hearings in a competent manner. All Administrative Law Judges shall serve at the discretion of the Commissioner, who shall maintain uniform criteria for assessing each Administrative Law Judge's qualifications to serve.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge is vested with full authority in the conduct of the hearing process, and is responsible for conducting hearings in accordance with the Rules established by the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge shall have the authority to do the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> administer oaths and affirmations;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> sign and issue subpoenas;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> rule upon offers of proof;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> regulate the course of the hearing and govern the conduct of the participants;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> rule on, admit, exclude, or limit evidence;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> examine witnesses;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> set the time and place for hearings and continuances thereof and fix the time for filing briefs and other documents;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> rule on all motions;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> provide for the taking of testimony by deposition or interrogatory;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(j)">(j)</a></td> <td valign="top" style="text-align:left" class="leftalign"> take official notice as prescribed in Rule <a title="350-4-.19" href="350-4-.19">350-4-.19</a>; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.08(4)(k)">(k)</a></td> <td valign="top" style="text-align:left" class="leftalign"> take any other action appropriate to dispose of the case in controversy.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/350-4-.09" name="350-4-.09" title="350-4-.09">Rule 350-4-.09 Disqualification of the Administrative Law Judge</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.09(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An Administrative Law Judge shall voluntarily withdraw from any proceedings in which he cannot render a fair and impartial decision for any reason.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.09(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A party may request the disqualification of an Administrative Law Judge by filing a written request or motion therefor accompanied by an affidavit stating in detail the grounds upon which it is claimed that a fair and impartial hearing cannot be given or that the Administrative Law Judge has an interest in the proceeding. The Administrative Law Judge shall immediately present the affidavit to the Commissioner of the Department who shall: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.09(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> investigate the allegation, advise the complaining party in writing of the decision granting or denying the request to disqualify the Administrative Law Judge, and mail a copy of the decision to all other parties; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.09(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> reassign the case to another Administrative Law Judge without investigation.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.09(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Should the Commissioner determine to remove an Administrative Law Judge during the pendency of a case, any party shall have the right within five days of receiving notice of such removal to present its objections thereto in writing to the Commissioner as part of the Hearing Record. The Commissioner shall respond in writing to such objections within five (5) days of his receipt thereof, and a copy of his response shall also become part of the Hearing Record.</td> </tr> </table> <h2><a href="/GAC/350-4-.10" name="350-4-.10" title="350-4-.10">Rule 350-4-.10 Ex Parte Communications</a></h2> <P>Commencing with the appointment of an Administrative Law Judge, no person shall communicate <I>ex parte</I> with such Administrative Law Judge relating to the merits of the proceeding until after the issuance of a final decision unless all parties involved in the proceedings are informed of the communication before or within a reasonable time after such communication occurs and no prejudice to any party results. If the Administrative Law Judge receives a communication prohibited by this Rule, (s)he shall forthwith notify all other parties of the receipt of such communication and disclose the substance of the communication for the parties' consideration in determining whether action is necessary in response.</P> <h2><a href="/GAC/350-4-.11" name="350-4-.11" title="350-4-.11">Rule 350-4-.11 Notice of Hearing</a></h2> <P>As soon as practicable after being appointed to hear a case, the Administrative Law Judge shall issue a notice of hearing, stating the time and place of the hearing, the legal authority and jurisdiction pursuant to which the hearing was requested, the issues to be addressed, and the right of parties to subpoena witnesses and documentary evidence, to secure testimony by deposition or interrogatories when necessary, to be represented by legal counsel and to respond and present evidence on all issues involved. The notice may incorporate by reference information set forth in pleadings.</P> <h2><a href="/GAC/350-4-.12" name="350-4-.12" title="350-4-.12">Rule 350-4-.12 Pre-Hearing Conferences</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge may, either <I>sua sponte</I> or at the request of any party, direct the parties or their authorized representatives to appear at a specified time and place for one or more conferences before or during a hearing or to submit written proposals or correspondence for the purpose of considering any of the matter set forth in Paragraph (2) of this Rule. At the discretion of the Administrative Law Judge, pre-hearing conferences may be conducted in whole or in part via telephone.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> In conferences held or in proposals submitted pursuant to Subsection (1) of this Rule, the following matters may be considered: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> settlement of the matter;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the contemplated use of a schedule for the completion of prehearing procedures and the submission and disposition of all prehearing motions;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> simplification, clarification, amplification, or limitation of the issues;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> admissions and stimulations of facts and of the genuineness and admissibility of documents;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the identity of persons expected to be called as witnesses by any party and the substance of their anticipated testimony;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the identification of expert witnesses expected to be called by any party to testify, the substance of the facts and opinions to which an expert witness is expected to testify, and a summary of the grounds of each opinion;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> matters of which official notice by the Administrative Law Judge is sought;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> objections to the introduction into evidence at the hearing of any written testimony, documents, papers, exhibits, or other submissions proposed by any party; provided that, at any time before the end of the hearing on the merits any party may make and the Administrative Law Judge shall consider and either rule upon, or reserve a ruling upon, motions to strike testimony or other evidence on the grounds of relevance, competency or materiality; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(2)(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> such other matters as may expedite adjudication of the matter.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.12(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge may issue an order which recites the action taken at the conference and any agreements made by the parties as to any of the matters considered, and which limits the issues for hearing to those not disposed of by admissions or agreement of the parties.</td> </tr> </table> <h2><a href="/GAC/350-4-.13" name="350-4-.13" title="350-4-.13">Rule 350-4-.13 Time and Place of Hearing</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.13(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The hearing shall be conducted at the offices of the Department of Medical Assistance unless exigent circumstances necessitate a different venue, and at a reasonable time and date. Reasonable notice of the time and location shall be given to all parties prior to the scheduled hearing. In setting the hearing, the Administrative Law Judge shall consider those cases pending before other Administrative Law Judges, and shall accommodate the needs of the parties as far as practicable.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.13(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge may change the time and place of the hearing <I>sua sponte</I>, for good cause shown by any party, or per the mutual assent of all parties. Reasonable notice of such action shall be given to all parties.</td> </tr> </table> <h2><a href="/GAC/350-4-.14" name="350-4-.14" title="350-4-.14">Rule 350-4-.14 Continued and Reopened Hearings</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge may continue and/or reopen a hearing: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> on the Administrative Law Judge's own motion,</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> at the request of any party, only upon a showing of good cause, or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> upon agreement by the parties.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Notice of the time and place of a continued or reopened hearing: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> may be oral if the continuance or reopening is ordered during a conference or hearing session, or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.14(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> shall be in writing to all parties, if ordered outside a conference or hearing session.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/350-4-.15" name="350-4-.15" title="350-4-.15">Rule 350-4-.15 Default; Abandonment</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.15(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If a party fails to appear at a hearing after receiving notice thereof, the Administrative Law Judge shall proceed with the hearing in the absence of the party or dismiss the action on motion of any party or <I>sua sponte.</I></td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.15(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If the party requesting a hearing fails to take action to advance his case for a continuous period of two years, the request for hearing shall be deemed abandoned and shall be dismissed with prejudice by the Administrative Law Judge.</td> </tr> </table> <h2><a href="/GAC/350-4-.16" name="350-4-.16" title="350-4-.16">Rule 350-4-.16 Discovery</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.16(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Discovery is limited to the following. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.16(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A party, upon written request made to another party within a reasonable time prior to the hearing, is entitled to: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.16(1)(a)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> obtain the names, addresses, and telephone numbers of the witnesses which the other party intends to call to testify at the hearing;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.16(1)(a)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> inspect and make a copy of all documents which the party proposes to offer into evidence.</td> </tr> </table> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.16(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any denial of discovery by a party shall be in writing and shall be accompanied by a written statement describing the specific reasons for denial as to each item of discovery denied. Such a denial shall be mailed within thirty (30) calendar days from the date of filing the request for discovery.</td> </tr> </table> <h2><a href="/GAC/350-4-.17" name="350-4-.17" title="350-4-.17">Rule 350-4-.17 Subpoenas</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.17(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge shall have the authority to issue subpoenas requiring the attendance and testimony of witnesses and the production of objects or documents at depositions or hearing.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.17(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Every subpoena shall be prepared by the requesting party and issued by the Administrative Law Judge on behalf of the Commissioner, shall state the title of the action, and shall command each person to whom it is directed to attend and give testimony or produce objects or documents in his possession or control or to do both at a time and place therein specified. Requests for subpoenas shall be filed at least five (5) days prior to the hearing or deposition at which the attendance of the witness or the production of the documents or objects is sought, unless there is good cause shown for submitting a request less than five (5) days in advance. The party requesting the subpoena shall be responsible for serving the same sufficiently in advance of the hearing to secure the attendance of the witness or the availability of such objects or documents at the title of the hearing.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.17(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Failure of appearance by a witness, whether required by subpoena or not, may constitute grounds for a continuance or for other action. In determining what action to take, the Administrative Law Judge shall consider the materiality of the testimony, documents, or objects sought, potential prejudice and inconvenience to the parties, and the likelihood of obtaining compliance with a subpoena. The Administrative Law Judge may order whatever action he deems appropriate to the circumstances.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.17(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When a subpoena is disobeyed, any party may apply to the superior court of the county where the case is being heard for an order requiring obedience. Failure to comply with such order shall be cause for punishment as for contempt of court.</td> </tr> </table> <h2><a href="/GAC/350-4-.18" name="350-4-.18" title="350-4-.18">Rule 350-4-.18 Depositions</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> At any time during the course of a proceeding, the Administrative Law Judge may, in his discretion, order that the testimony of a witness be taken by deposition. Application to take a deposition in lieu of personal appearance at the hearing shall be made by motion. Such motion shall state the name and address of the witness, the time when, the place where, and the subject matter about which the witness would be deposed, the relevance of such testimony, and the specific reason why the witness cannot or will not appear to testify at the hearing.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> In the exercise of his discretion in deciding whether to order testimony by deposition, the Administrative Law Judge shall consider, among other factors: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> whether requiring the appearance of a witness subject to subpoena would endanger that person's health or work an undue hardship; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> whether ordering the taking of testimony by deposition will result in an undue cost or burden on any other party, an undue delay in the proceedings, or any injury to other parties from the delay.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If the Administrative Law Judge orders testimony by deposition, be may specify whether the scope of examination upon deposition should be limited in any way, and if so, how.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Subject to appropriate rulings on objections, a deposition shall be received in evidence without the need to be tendered as if the testimony contained therein had been given by the witness before the Administrative Law Judge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Nothing in this Rule shall be read to allow the use of depositions in discovery; provided, however, that if two parties voluntarily agree to discovery by deposition, they will not be prevented from engaging in such deposition or using the testimony or evidence thereby elicited.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.18(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The cost of a deposition shall be borne by the party requesting it, or according to voluntary agreement of the parties affected by the testimony elicited thereby.</td> </tr> </table> <h2><a href="/GAC/350-4-.19" name="350-4-.19" title="350-4-.19">Rule 350-4-.19 Pleadings and Amendments; Automatic Filings</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.19(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The notice of adverse action issued by the Department and the request for hearing submitted by the provider shall constitute the pleadings in each contested case and automatically shall be included in the Record. The pleadings shall be transmitted by the Department to the Administrative Law Judge at the time of the Administrative Law Judge's appointment to the case.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.19(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any party may amend any pleading without leave of the Administrative Law Judge until the tenth day prior to the date set for the hearing on the matter. Thereafter a party may amend its pleadings only by written consent of the adverse party or by leave of the Administrative Law Judge. Leave shall be freely given when justice so requires. If an amendment is made to any pleading to which a response or reply is necessitated, a response or reply to such amendment shall be filed within ten days after service of the amended request or as otherwise ordered by the Administrative Law Judge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.19(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Copies of the notice of proposed adverse action issued by the Department and the request for Administrative Review filed by the provider which preceded the Pleadings shall be filed automatically by the Department with the Administrative Law Judge upon his appointment. Such filings shall include all supporting documentation transmitted therewith. All documents so filed shall automatically become part of the Record.</td> </tr> </table> <h2><a href="/GAC/350-4-.20" name="350-4-.20" title="350-4-.20">Rule 350-4-.20 Rules of Evidence; Official Notice</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.20(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Relevant allegations of fact contained in the Pleadings and automatic filings shall be deemed admitted unless specifically contested.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.20(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Irrelevant, immaterial, or unduly repetitious evidence shall be excluded. The rules of evidence as applied in the trial of civil, nonjury cases in the superior courts of Georgia shall be followed. When necessary to ascertain facts not reasonably susceptible of proof under such rules, evidence not admissible thereunder may be admitted, except where precluded by statute, if it is of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs or if it consists of a report or evaluation of a type routinely submitted to or relied upon by the Department in the normal course of its business. The rules of privilege recognized by law shall be given full effect. Objections to evidentiary offers may be made and shall be noted in the record. Subject to these requirements, when a hearing will be expedited and the interests of the parties will not be prejudiced substantially, any part of the evidence may be received in written form.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.20(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Documentary evidence may be received in the form of copies or excerpts if the original is not readily available or for the convenience of the parties if no substantial prejudice results thereby. Upon request, parties shall be given an opportunity to compare the proffered copy with the original to verify its correctness.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.20(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Summaries of voluminous documents may be admitted into evidence, provided that the parties agree or the author of the summary is available for cross-examination. The summarized documents themselves need not be admitted into evidence, provided that all parties are accorded a reasonable opportunity to inspect the documents so summarized and no substantial injustice would result from admission of the summary alone.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.20(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Official notice may be taken of judicially cognizable facts. In addition, official notice may be taken of generally recognized technical or scientific facts within the agency's specialized knowledge. Parties shall be notified either before or during the hearing, by reference in preliminary reports or otherwise, of the material requested to be noticed, including any staff memoranda or data, and they shall be afforded an opportunity to contest the material so noticed. The Department's experience, technical competence, and specialized knowledge may be utilized in the evaluation of the evidence.</td> </tr> </table> <h2><a href="/GAC/350-4-.21" name="350-4-.21" title="350-4-.21">Rule 350-4-.21 Substitution of Parties; Intervention</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.21(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge may, upon motion and in the exercise of discretion, permit such substitution of parties as justice requires, provided that the original party and the party to be substituted otherwise qualify individually as parties to the proceedings under all applicable requirements.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.21(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any person seeking to intervene shall file a motion stating therein the specific grounds upon which intervention is sought and a pleading setting forth the claim or defense for which intervention is sought. The person shall also establish the basis for qualification as a party to the proceedings. The Administrative Law Judge shall grant or deny such motion and may limit the factual or legal issues which may be raised by an intervenor in order to avoid undue delay or prejudice to the adjudication of the rights of the original parties.</td> </tr> </table> <h2><a href="/GAC/350-4-.22" name="350-4-.22" title="350-4-.22">Rule 350-4-.22 Consolidation and Severance</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.22(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When two or more providers appeal matters involving common issues of law or fact, the appeals may be consolidated by the Department or by the appointed Administrative Law Judge(s) and heard together if it appears that a joint hearing would serve to expedite or simplify consideration of those issues and that no party would be prejudiced thereby.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.22(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> In consolidated hearings, the Administrative Law Judge may limit direct examination and cross-examination to matters which have not been adequately covered by previous testimony or evidence.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.22(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Whenever the Administrative Law Judge determines that it would be more conducive to an expeditious, full, and fair hearing for any party or issue to be heard in separate proceedings, he may in the exercise of his discretion, upon motion of any party or <I>sua sponte</I>, sever the party or issue for such separate hearing.</td> </tr> </table> <h2><a href="/GAC/350-4-.23" name="350-4-.23" title="350-4-.23">Rule 350-4-.23 Service</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.23(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The party filing any submission shall simultaneously serve a copy of each submission upon each party of record. Service shall be by mail or personal delivery. Service by mail shall be complete upon mailing by first class mail, with proper postage attached, to a party's address of record.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.23(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Every submission shall be accompanied either by an acknowledgement of service from the person served or his representative, or by a document stating the date, place and manner of service and the name and address of the person served.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.23(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge shall return to the sender, without reviewing the contents thereof, any submission not accompanied by evidence of service as provided herein, along with an explanation for the return.</td> </tr> </table> <h2><a href="/GAC/350-4-.24" name="350-4-.24" title="350-4-.24">Rule 350-4-.24 The Hearing</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The hearing shall be opened with reasonable promptness as fixed in the "notice of hearing."</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All Department hearings shall be accessible to the public, subject to requirements for safeguarding confidential information.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> In all hearings, taking of testimony shall be under oath.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The rules applied to civil cases in the superior courts of Georgia concerning the burdens of persuasion and going forward with the evidence shall be followed.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Both the provider and the Department shall have the opportunity to do the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> bring witnesses;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> establish all pertinent facts and circumstances through competent evidence;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(5)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> advance any arguments relevant to the proceedings without undue interference; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(5)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> question or refute any testimony or evidence, including the opportunity to confront and cross-examine adverse witnesses.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Documents, reports, data, and other information used by the parties in the course of the hearing which were obtained on a confidential basis or are subject to legal restrictions with respect to their disclosure, shall be classified and labeled by the Administrative Law Judge "Confidential and Privileged - Not for Release." All matter so classified shall be subject neither to public inspection nor to production or disclosure until and unless the Administrative Law Judge, the Department, or court of competent jurisdiction determines that such inspection, production, or disclosure is appropriate and authorized by law.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.24(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If issues are raised at the hearing which are different from the issues for which the hearing was requested, the Administrative Law Judge may conduct the hearing on the newly-emerged issues only on a showing of good cause by the party raising the issue(s). In such instances the hearing shall be conducted in a manner which will afford adequate opportunity to all parties to respond to the newly-raised issues.</td> </tr> </table> <h2><a href="/GAC/350-4-.25" name="350-4-.25" title="350-4-.25">Rule 350-4-.25 Motions</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.25(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An application to the Administrative Law Judge for an order requiring any party to take any action or entering any interlocutory ruling shall be made by motion. Unless made during the hearing, motions shall be in writing, shall state specifically the grounds therefor, and shall describe the action or order sought. Motions that may be made in conformance with this Rule include, without being limited to, motions for more definite statement, for dismissal (<I>e.g.</I>, for lack of jurisdiction over the subject matter or parties, for failure to state a claim upon which relief may be granted or for any other ground), for summary determination, to amend, to intervene, to substitute parties, to consolidate or sever parties or issues, to take depositions or interrogatories, to secure testimony, or to re-open the Record to admit newly-discovered evidence. A copy of any written motion shall be served upon all parties in accordance with Section .23 of this Chapter.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.25(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Within 20 days after service of any written motion, any party to the proceedings may file a response to the motion. The time for response may be shortened or extended by the Administrative Law Judge for good cause shown.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.25(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge may, either <I>sua sponte</I> or at the request of any party, determine in his discretion whether the nature and complexity of the motion justifies a hearing and notify the parties accordingly. A request for a hearing on a motion must be made in writing and filed by the date the response to the motion is to be filed. Notice of hearing on a motion shall be given by the Administrative Law Judge at least 5 days prior to the date set for hearing unless such notice is waived by all parties. At the discretion of the Administrative Law Judge, such hearings may be conducted, in whole or in part, via telephone. If a hearing on a motion is not requested or deemed justified, the Administrative Law Judge shall rule upon the motion forthwith.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.25(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Multiple motions may be consolidated for hearing or heard at a pre-hearing conference. The Administrative Law Judge may call for the submission of briefs, for oral argument, or both, either in support of or in opposition to any motion.</td> </tr> </table> <h2><a href="/GAC/350-4-.26" name="350-4-.26" title="350-4-.26">Rule 350-4-.26 Summary Determination</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.26(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any party may move, if supported by affidavits or other probative evidence, for a summary determination in its favor upon any of the issues being adjudicated on the basis that there is no genuine issue of material fact for determination. Such a motion must be filed and served on all parties no later than 20 days after service of the Notice of Hearing; provided that, upon good cause shown, the motion may be filed at any time before the close of the hearing.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.26(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When a motion for summary determination is made and supported as provided in this Rule, a party opposing the motion may file and serve a response or a countermotion. The respondent may not rest upon mere allegations or denials, but must show, by affidavit or other probative evidence, that there is a genuine issue of material fact for determination in the hearing.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.26(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Affidavits shall be made upon personal knowledge, shall set forth facts that would be admissible in evidence, and shall show affirmatively that the affiant is competent to testify to the matters stated therein. Copies of all papers or parts thereof referred to in an affidavit conforming to these rules shall be attached thereto and served therewith.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.26(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If all factual issues are decided by summary determination, no hearing will be held and the Administrative Law Judge shall prepare a decision. If summary determination is denied or if partial summary determination is granted, the Administrative Law Judge shall issue a memorandum opinion and order, interlocutory in nature, and the hearing will proceed on the remaining issues.</td> </tr> </table> <h2><a href="/GAC/350-4-.27" name="350-4-.27" title="350-4-.27">Rule 350-4-.27 The Hearing Record</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge shall compile an official Record of the hearing, which shall include: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all pleadings, automatic filings, motions, and intermediate rulings;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> a transcript of the oral testimony received in evidence;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all documents received in evidence;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all depositions and interrogatories or excerpts therefrom admitted into evidence;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> a statement of matters officially noticed;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all offers of proof, objections thereto, and ruling thereon not otherwise reflected in the transcript;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all physical evidence admitted in the course of the hearing; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(1)(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all demonstrative evidence admitted during the course of the hearing.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Oral testimony shall be recorded and transcribed therefrom for use by the Administrative Law Judge in rendering a decision. Copies of such transcripts may be purchased for a fee set periodically by the Department and available for disclosure upon a party's inquiry.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Record shall be closed upon receipt by the Administrative Law Judge of the official transcript and all evidence, pleadings, briefs, memoranda, and other documents authorized or required under these Rules.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.27(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The hearing Record shall be available to the parties or their authorized representatives at any reasonable time.</td> </tr> </table> <h2><a href="/GAC/350-4-.28" name="350-4-.28" title="350-4-.28">Rule 350-4-.28 Decision of the Administrative Law Judge</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.28(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The decision of the Administrative Law Judge shall be based exclusively on competent evidence and other material introduced pursuant to this Chapter. It shall specify the reason for the decision and identify the supporting evidence and regulations, and include findings of fact and conclusions of law.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.28(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge's decision shall be issued to the Department within ninety (90) days from the Department's timely receipt of a hearing request conforming to the requirements of Rule <a title="350-4-.05" href="350-4-.05">350-4-.05</a>, and within thirty (30) days from the close of the Record. However, if, in the Administrative Law Judge's discretion, the complexities of the issues, the length of the case record, scheduling difficulties, agreement of the parties, or any other consideration justifies an extension of time, the Administrative Law Judge may extend the time in which an initial decision must be rendered; provided, however, that such extension shall not exceed ninety (90) days from the close of the Record.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.28(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department shall, upon receipt of the Administrative Law Judge's decision, furnish a copy thereof to each party by Certified Mail, accompanied by a cover Notice informing each party of its appeal rights.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.28(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrative Law Judge's decision shall be accessible to the public, subject to requirements for safeguarding confidential information.</td> </tr> </table> <h2><a href="/GAC/350-4-.29" name="350-4-.29" title="350-4-.29">Rule 350-4-.29 Appeal of Administrative Law Judge's Decision</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.29(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any provider may petition for review of the Administrative Law Judge's decision within five (5) days from the date of that party's receipt of the decision. Such request shall be in writing and addressed to the Commissioner and shall state the legal or factual errors upon which the appeal is based.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.29(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If any party fails to request review within five (5) days of the date of receipt of the adverse decision, that party shall have waived its right to any further review or revision of that decision.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.29(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If a party requests a transcript of the proceedings, after receipt of the initial decision, that party will have an additional five (5) days from the date of receipt of the transcript in which to submit a written statement of legal or factual errors. However, a request for a transcript shall not in any manner lengthen the time [five (5) days from receipt of the decision] in which a request for review must be submitted.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.29(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The final decision by the Commissioner shall be made within thirty (30) days after receipt of the request for review and shall be accessible by the public, subject to requirements for safeguarding confidential information. The parties shall be notified in writing of the final decision and of the provider's right to judicial review. The final decision and notice to the provider shall state the effective date of the decision. Should the Commissioner fail to issue his decision within thirty (30) days from his receipt of a request for review, the Administrative Law Judge's Decision shall be deemed affirmed, and the provider may proceed to appeal pursuant to Rule <a title="350-4-.30" href="350-4-.30">350-4-.30</a>.</td> </tr> </table> <h2><a href="/GAC/350-4-.30" name="350-4-.30" title="350-4-.30">Rule 350-4-.30 Appeal of the Commissioner's Decision</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.30(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any provider adversely affected by a final decision of the Commissioner may have review thereof by appeal to the superior court in the county of residence of the provider or to the Superior Court of Fulton County. Such appeal shall be by petition which shall be filed in the clerk's office in such court within thirty (30) days after the final decision of the Commissioner. Such appeal shall be held in accordance with the "Administrative Procedure Act," Official Code of Georgia Annotated, Title 50, Chapter 13. A provider shall not appeal an adverse decision of the Commissioner to the superior court of the county of residence of the provider or the Superior Court of Fulton County unless the provider first exhausts the administrative remedies within the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.30(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The petition shall set forth the names of parties making the appeal, the decision being appealed, and the reason it is claimed to be erroneous.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.30(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Enforcement of the decision being appealed shall not be stayed until and unless so ordered and directed by the reviewing court. Upon filing such petition, the petitioner shall serve on the Commissioner a copy thereof in the manner prescribed by law for service of process.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-4-.30(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Upon receipt of the appeal, the Commissioner shall transmit a certified copy of the hearing Record and a copy of any appeal therefrom to the superior court within thirty (30) days of receipt of the appeal.</td> </tr> </table> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/350-4-.01" name="350-4-.01" title="350-4-.01">Rule 350-4-.01 Hearings Conducted by the Department of Medical Assistance</a></li><li><a href="/GAC/350-4-.02" name="350-4-.02" title="350-4-.02">Rule 350-4-.02 Hearings Conducted by the Department of Human Resources</a></li><li><a href="/GAC/350-4-.03" name="350-4-.03" title="350-4-.03">Rule 350-4-.03 Right to Representation</a></li><li><a href="/GAC/350-4-.04" name="350-4-.04" title="350-4-.04">Rule 350-4-.04 Administrative Review</a></li><li><a href="/GAC/350-4-.05" name="350-4-.05" title="350-4-.05">Rule 350-4-.05 Hearing Requests</a></li><li><a href="/GAC/350-4-.06" name="350-4-.06" title="350-4-.06">Rule 350-4-.06 Dismissal of Hearing Requests</a></li><li><a href="/GAC/350-4-.07" name="350-4-.07" title="350-4-.07">Rule 350-4-.07 Informal Disposition; Settlement</a></li><li><a href="/GAC/350-4-.08" name="350-4-.08" title="350-4-.08">Rule 350-4-.08 The Administrative Law Judge</a></li><li><a href="/GAC/350-4-.09" name="350-4-.09" title="350-4-.09">Rule 350-4-.09 Disqualification of the Administrative Law Judge</a></li><li><a href="/GAC/350-4-.10" name="350-4-.10" title="350-4-.10">Rule 350-4-.10 Ex Parte Communications</a></li><li><a href="/GAC/350-4-.11" name="350-4-.11" title="350-4-.11">Rule 350-4-.11 Notice of Hearing</a></li><li><a href="/GAC/350-4-.12" name="350-4-.12" title="350-4-.12">Rule 350-4-.12 Pre-Hearing Conferences</a></li><li><a href="/GAC/350-4-.13" name="350-4-.13" title="350-4-.13">Rule 350-4-.13 Time and Place of Hearing</a></li><li><a href="/GAC/350-4-.14" name="350-4-.14" title="350-4-.14">Rule 350-4-.14 Continued and Reopened Hearings</a></li><li><a href="/GAC/350-4-.15" name="350-4-.15" title="350-4-.15">Rule 350-4-.15 Default; Abandonment</a></li><li><a href="/GAC/350-4-.16" name="350-4-.16" title="350-4-.16">Rule 350-4-.16 Discovery</a></li><li><a href="/GAC/350-4-.17" name="350-4-.17" title="350-4-.17">Rule 350-4-.17 Subpoenas</a></li><li><a href="/GAC/350-4-.18" name="350-4-.18" title="350-4-.18">Rule 350-4-.18 Depositions</a></li><li><a href="/GAC/350-4-.19" name="350-4-.19" title="350-4-.19">Rule 350-4-.19 Pleadings and Amendments; Automatic Filings</a></li><li><a href="/GAC/350-4-.20" name="350-4-.20" title="350-4-.20">Rule 350-4-.20 Rules of Evidence; Official Notice</a></li><li><a href="/GAC/350-4-.21" name="350-4-.21" title="350-4-.21">Rule 350-4-.21 Substitution of Parties; Intervention</a></li><li><a href="/GAC/350-4-.22" name="350-4-.22" title="350-4-.22">Rule 350-4-.22 Consolidation and Severance</a></li><li><a href="/GAC/350-4-.23" name="350-4-.23" title="350-4-.23">Rule 350-4-.23 Service</a></li><li><a href="/GAC/350-4-.24" name="350-4-.24" title="350-4-.24">Rule 350-4-.24 The Hearing</a></li><li><a href="/GAC/350-4-.25" name="350-4-.25" title="350-4-.25">Rule 350-4-.25 Motions</a></li><li><a href="/GAC/350-4-.26" name="350-4-.26" title="350-4-.26">Rule 350-4-.26 Summary Determination</a></li><li><a href="/GAC/350-4-.27" name="350-4-.27" title="350-4-.27">Rule 350-4-.27 The Hearing Record</a></li><li><a href="/GAC/350-4-.28" name="350-4-.28" title="350-4-.28">Rule 350-4-.28 Decision of the Administrative Law Judge</a></li><li><a href="/GAC/350-4-.29" name="350-4-.29" title="350-4-.29">Rule 350-4-.29 Appeal of Administrative Law Judge's Decision</a></li><li><a href="/GAC/350-4-.30" name="350-4-.30" title="350-4-.30">Rule 350-4-.30 Appeal of the Commissioner's Decision</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 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