Pursuant to 18 NYCRR ยง 358-4.3(c) (1), the Managed Care Organization (MCO) can request a waiver of personal appearance and submit to OAH, prior to the hearing date, a waiver request and evidentiary packet. Waiver requests will be reviewed and granted on a case-by-case basis. No "blanket" waivers of appearance will be granted at this time.
Even in situations where a waiver of appearance has been granted, the Administrative Law Judge (ALJ) may require the testimony of an MCO representative at the time of the hearing. A primary contact person and a designated back-up contact must be available during the course of the hearing to accept a telephone call from the ALJ. The primary and back-up contact persons' names and telephone numbers should be included on the request for waiver.
It is anticipated that waivers will only be requested by MCOs on matters concerning clinical issues, since enrollment issues are handled by the local social services district, whose representative should expect to appear at the scheduled hearing.
|
