OAR 410-165-0120: Appeals

(1) The appeals process for the Program is governed by 42 CFR 495.370 and the Authority’s Provider Appeals Rules in chapter 410, division 120. (2) Pursuant to 42 CFR 495.312 and 42 CFR 495.370, the Authority may have CMS conduct the audits and handle any subsequent appeals of whether eligible hospitals are meaningful EHR users. (3) A provider who applies for a Medicaid EHR incentive payment may appeal the Program’s decision. Appeals are governed by the Division’s Provider Appeal Rules OAR chapter 410, division 120. The provider’s appeal shall note the specific reason for the appeal, due to one or more of the following issues: (a) An incentive payment; (b) An incentive payment amount; (c) A provider eligibility determination; (d) The demonstration of adopting, implementing, or upgrading; or (e) Meaningful use eligibility other than a meaningful use eligibility issue where CMS handles the appeal, as provided in section (2) of this rule.