R410-14-14. Proposed Decision and Final Agency Review  


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  •   (1) At the conclusion of the hearing, the hearing officer shall take the matter under advisement and submit a recommended decision to the DMHF Director or the director's designee. The recommended decision is based on the testimony and evidence entered at the hearing, Medicaid policy and procedure, and legal precedent.

      (2) The recommended decision must contain findings of fact and conclusions of law.

      (3) The DMHF Director or the director's designee may:

      (a) adopt the recommended decision or any portion of the decision;

      (b) reject the recommended decision or any portion of the decision, and make an independent determination based upon the record; or

      (c) remand the matter to the hearing officer to take additional evidence, and the hearing officer thereafter shall submit to the DMHF director or the director's designee a new recommended decision.

      (4) The director or designee's decision constitutes final administrative action and is subject to judicial review.

      (5) DMHF shall send a copy of the final administrative action to each party or representative and notify them of their right to judicial review.

      (6) The parties shall comply with a final decision from the director reversing the agency's decision within 10 calendar days.

      (7) The DOH Executive Director shall review all recommended decisions to determine approval of medical assistance for an organ transplant. The Executive Director's decision constitutes final administrative action and is subject to judicial review.