N.M. Admin. Code § 7.5.5.18

Current through Register Vol. 35, No. 23, December 10, 2024

Section 7.5.5.18 - ADMINISTRATIVE HEARING

A. If the provider wishes to appeal the result of the administrative review, the provider must submit a written request to the division within 10 working days from the date of issuance of the assigned bureau chief or designee's written decision.

B.Hearing process:

(1) Hearing will be conducted by a hearing officer appointed by the secretary.

(2) Hearings shall be conducted in Santa Fe, New Mexico, unless the appellant can show significant hardship sufficient to require the case be held in a different location.

(3) Due to federal and state laws regarding the confidentiality of protected health information, all hearings held pursuant to this section shall be closed to the public.

(4) The hearing shall be recorded on audio recording equipment. The hearing officer shall maintain the recording. No other recordings may be made except with the permission of the hearing officer.

(5) Any hearing provided for in this rule may be held telephonically, with the consent of the parties.

(6) A request for a telephonic hearing must be made no later than 10 business days prior to the date of the hearing; notice of the telephonic hearing shall be given to all parties and shall include all necessary telephone numbers;

(6) The department shall schedule and hold the hearing no later than 60 calendar days from the date the department receives the appellant's request for hearing. The hearing officer may extend the 60-day time period for good cause shown, or the parties may extend that period by mutual agreement.

(7) The department shall issue notice of the hearing at least fifteen days prior to the scheduled date of the hearing. The notice shall include a statement of the time, place, and nature of the hearing.

(9) An appellant's failure to appear at the hearing at the date and time noticed shall constitute a default unless good cause for the failure to appear is shown.

(10) All parties shall be given the opportunity to respond and present evidence and argument on relevant issues.

(11) A party may be represented by a person licensed to practice law in New Mexico or a non-lawyer representative or may represent himself or herself.

(12) The hearing officer shall create a record of the proceedings which shall include the following:

(a) all pleadings, motions, and rulings;

(b) evidence and briefs received or considered;

(c) a statement of any matters officially noticed;

(d) offers of proof, objections, and rulings thereon;

(e) proposed findings and conclusions; and

(f) any action recommended by the hearing officer.

(13) Unless the hearing officer determines a different procedure is appropriate, the hearing officer shall conduct the hearing as follows:

(a) opening statements by the appellant and the department;

(b) upon conclusion of the opening statements, the department shall present its case;

(c) upon conclusion of the departments case, the appellant may present his or her case;

(d) upon conclusion of either party's case, the opposing party may present rebuttal evidence; and

(e) after presentation of the evidence by the parties, the parties may present closing arguments.

(14) The rules of evidence as applied in courts do not apply in the proceedings; any relevant evidence shall be admitted; irrelevant, immaterial, or unduly repetitious evidence may be excluded.

(15) The department shall be required to prove its case by a preponderance of the evidence.

(16) The parties may submit briefs including findings of fact and conclusions of law for consideration by the hearing officer. All briefs must be submitted 15 days after the conclusion of the hearing.

(17) No later than 30 calendar days after the last submission by a party, the hearing officer shall prepare and submit to the secretary a written recommendation of action to be taken by the secretary; the recommendation shall propose sustaining, reversing, or modifying the proposed action of the department.

(18) The secretary shall issue a final written decision accepting or rejecting the hearing officer's recommendation in whole or in part no later than 30 calendar days after receipt of the hearing examiner's recommendation; the final decision shall identify final action taken. Service of the secretary's final decision shall be made upon the appellant by registered or certified mail.

N.M. Admin. Code § 7.5.5.18

Adopted by New Mexico Register, Volume XXIX, Issue 20, October 30, 2018, eff. 10/30/2018