9 NYCRR Part 9730 - Executive Department

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Source version current through May 15, 2022

All 5 displayed sections in this Part carry the same compiled date. Status and warnings stay on each section.

9 NYCRR 9730.1 - Introduction

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: May 15, 2022

The rights and obligations of the contractor are governed by this Part.

9 NYCRR 9730.2 - Proposed actions

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: May 15, 2022

When the contractor proposes to deny, discontinue, suspend or reduce coverage, it shall:

(a)review, or cause to be reviewed, the proposed action to determine its correctness on the basis of the available evidence in support of such action which shall be included in the case file;

(b)if, after the review, it is decided that the proposed action would be correct, send a timely and adequate notice of the proposed action to the applicant/participant at least 10 days before the date the action is to be taken on forms approved by the State;

(c)upon request of the applicant or participant, promptly reconsider its determination and send written notice of its determination after reconsideration to the applicant/participant, together with the information concerning the applicant's/participant's right to a fair hearing as required by sections 9720.2 and 9720.3 of this Title.

9 NYCRR 9730.3 - Prehearing responsibilities

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: May 15, 2022

When the contractor is notified that a request for a fair hearing has been received, it shall:

(a)send the appellant or his/her representative copies of all documents to be submitted into evidence at the hearing in support of the contractor's action;

(b)provide copies of any document or information in the file if requested by appellant or his/her representative, without charge;

(c)take such action as is necessary to assure that an appropriate representative will appear at the hearing with the case file and a brief written summary including:

(1)the names, addresses, relationships and ages of persons affected;

(2)the decision or action which prompted the request for the fair hearing;

(3)a brief description of the facts, evidence and reasons allegedly supporting such decision or action, including identification of the specific provisions of law or regulations which allegedly support the action;

(4)the income determination prepared for the appellant; and

(5)a copy of its determination upon reconsideration.

9 NYCRR 9730.4 - Responsibilities and rights at the fair hearing

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: May 15, 2022

(a)The contractor must provide complete copies of its documentary evidence to the hearing officer at the fair hearing and to the appellant or his/her representative, if such documents were not already provided. Such documents must be provided without a charge.

(b)The contractor must provide a representative at the hearing along with the file and a written summary of the case.

(c)Such representative must have the authority to make binding decisions at the hearing on behalf of the contractor, including the authority to withdraw the action.

9 NYCRR 9730.5 - Compliance with fair hearing decision and mediation order

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: May 15, 2022

The contractor must promptly comply with all fair hearing decisions and initiate directives without delay, in accordance with this Part.

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