Practices and Procedures

96-1 Representation of a PNMI Facility

To enable the Division to identify the official representative of the provider and to know where communications should be sent, a written notification must be filed by the provider, pursuant to V.P.N.M.I.R. §1.11(b).

96-2 Extensions of Time

The Division's rules contain a number of time limits for providers. Because it is not always possible to meet these deadlines, the rules also contain provisions to permit the extension of time limits, at V.P.N.M.I.R. §§1.10(c) and 3.3(c).

96-3 Public Availability of Funding Applications and Other Financial Information Filed with the Division

Pursuant to 3 V.S.A. §317(b)(6) and V.P.N.M.I.R. §2.5(f) providers' financial records filed with the Division are public records and are available for inspection or copying.

96-4 Procedures for Administrative Review of Funding Application Findings

This issuance describes the steps necessary to appeal actions of the Division taken after review or audit of providers' funding applications, pursuant to V.P.N.M.I.R. §§11.1-11.3. Each step of this review procedure must be completed before further review is available. No appeal of funding application findings may be taken pursuant to V.P.N.M.I.R. §11.4, unless the Division's administrative review procedures have first been exhausted.

96-5 Form - Request for Work Papers

This form should be used whenever the provider needs to have access to the Division's work papers in order to review the calculations. Normally this form will be used to help the provider review the draft findings pursuant to V.P.N.M.I.R. §11.1(b) and for that purpose the form must be filed at the Division within 10 days after the provider receives the draft findings. The filing of a Request for Work Papers pursuant to V.P.N.M.I.R. §11.1(b) will automatically extend the time in which to file a Request for Informal Conference to 15 days after the provider's receipt of the work papers.

96-6 Form -Request for Informal Conference

This form should be used to initiate all administrative reviews of the Division's cost report findings. (V.P.N.M.I.R. §11.2) If a timely Request for Informal Conference is not filed, the provider is not entitled to any further administrative or judicial review of the cost report findings for the period in question.

96-7 Form - Notice of Request for Reconsideration

This form which consists of a cover sheet with a number of schedules should be used to initiate a formal administrative review of the Division’s findings (official action) issued after an informal conference. The form, along with the relevant supporting schedules, must be filed within 30 days of the provider’s receipt of the Official Action. If no timely Notice of Request for Reconsideration is filed, the provider is not entitled to further administrative review of the Official Action for the period in question. (V.P.N.M.I.R. §11.3)

2-14 Utilization Rate

As part of the annual rate setting process, a utilization rate will be established for each program. The utilization rate employed in the rate setting calculation is the greater of the Base Utilization Rate or the Average Utilization Rate, which are defined below.