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Code · North Carolina · Chapter 108C — Medicaid Provider Requirements

§ 108C-12. Appeals by Medicaid providers and applicants.

170 words·~1 min read·/nc/chapter-108c/108c-12

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§ 108C-12. Appeals by Medicaid providers and applicants.
(a)General Rule. - Notwithstanding any provision of State law or rules to the contrary, this section shall govern the process used by a Medicaid provider or applicant to appeal an adverse determination made by the Department.
(b)Appeals. - Except as provided by this section, a request for a hearing to appeal an adverse determination of the Department under this section is a contested case subject to the provisions of Article 3 of Chapter 150B of the General Statutes.
(c)Final Decision. - The Office of Administrative Hearings shall make a final decision within 180 days of the date of filing of the appeal with the Office of Administrative Hearings. The time to make a final decision shall be extended in the event of delays caused or requested by the Department.
(d)Burden of Proof. - The petitioner shall have the burden of proof in appeals of Medicaid providers or applicants concerning an adverse determination. (2011-399, s. 1; 2014-100, s. 12H.27(a).)
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