LD 1356
pg. 3
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LR 1441
Item 1

 
F.__By July 1, 2004 the department shall make available on its
publicly accessible site on the Internet the decisions in all
MaineCare provider appeals beginning January 1, 2004,
including the recommendations of the hearing officer and the
decision of the commissioner.

 
(1)__The site must include a search feature allowing
users to obtain information on specific issues of
interest.

 
(2)__The site must protect information that is personal
or confidential.

 
G.__In lieu of the appeal procedure provided in this
subsection, the parties may choose arbitration by a
qualified arbitrator or panel of arbitrators as provided in
this paragraph.__By January 1, 2004, the department shall
adopt rules to implement this paragraph that are consistent
with federal law and regulation.__Rules adopted pursuant to
this paragraph are routine technical rules as defined in
Title 5, chapter 375, subchapter 2-A.

 
(1)__The arbitrator or panel of arbitrators must be
selected and compensated as agreed by the parties.

 
(2)__Arbitration under this paragraph is available only
when the amount in controversy is $10,000 or less and
the subject matter in controversy is assessments,
recovery or recoupment orders, sanctions or
administrative fines.

 
(3)__A provider choosing arbitration under this
paragraph may waive any right of appeal.

 
H.__In an administrative appeal of an informal review
decision under this subsection, the department bears the
burden of proving a violation of law or rule by a
preponderance of the evidence.__If the department proves
that records of goods or services are defective, the
department may impose the sanction of total recoupment only
when the provider has failed to demonstrate by a
preponderance of the evidence that the disputed goods or
services were actually provided to eligible MaineCare
members.

 
The department shall provide funding for contractual services
under this subsection from within existing resources.

 
Sec. 3. 22 MRSA §48 is enacted to read:


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