N.Y. Comp. Codes R. & Regs. Tit. 12 §§ 325-4.6

Current through Register Vol. 46, No. 45, November 2, 2024

Section 325-4.6 - Procedure for hearing

In any hearing pertaining to the suspension or revocation of the authorization of a hospital or health maintenance organization, the following procedure shall apply:

(a) The hearing shall be conducted by the Medical Appeals Unit.

(b) The accused hospital or health maintenance organization shall be given 30 days' notice in writing, containing a brief statement of the charge or charges against such hospital or hospitals and health maintenance organizations and the time when and the place where such charge or charges will be heard. Such notice shall be served either personally or by mail. At least 10 days prior to the hearing date fixed in said notice, the accused hospital or health maintenance organization shall file an answer to such charges with the Medical Appeals Unit.

(c) At the hearing on such charge or charges, the accused hospital or health maintenance organization shall be entitled to have counsel present and to cross-examine witnesses. A verbatim record of the proceedings shall be made, and witnesses shall testify under oath.

(d) The Medical Appeals Unit in the conduct of a hearing shall not be bound by common law or statutory rules of evidence, or by technical or formal rules or procedure, except as provided herein; and may make such investigation or inquiry and conduct such hearing in the manner it deems advisable and necessary.

(e) A decision concurred in by two of the three members of the Medical Appeals Unit shall constitute the decision of the Medical Appeals Unit. The decision of the Medical Appeals Unit shall be advisory to the chairman and shall not be binding or conclusive.

(f) A copy of the record of the proceeding shall be submitted to the chair together with the report, findings and recommendation of the Medical Appeals Unit.

(g) Until final action is taken by the chair on the findings and recommendation of the Medical Appeals Unit, the accused hospital or health maintenance organization may continue to provide out-patient medical treatment and care under the Workers' Compensation Law, unless otherwise specifically ordered by the chair.

N.Y. Comp. Codes R. & Regs. Tit. 12 §§ 325-4.6