(A) The appellant and the department or county
(1) The parties shall
comply with the following service requirements:
(a) A certificate of service shall be attached to each
filing with the depository agent attesting to service of a copy on the other
party and the hearing examiner. Service is governed by rule 5 of the Ohio Rules
of Civil Procedure
8, 2016) except that any reference to "court" in rule 5 will be
interpreted to refer to the "depository agent."
(b) Only those brief, motions, memoranda, documents, and
other filings filed with the depository agent shall be considered part of the
hearing record. They must be filed with the depository agent within three days
after service on the other party in the hearing.
(c) All briefs, memoranda, motions, and other filings shall
be on eight-and-one half inch by eleven-inch paper and
(2) The appellant has the
burden of proof by a showing of clear and convincing evidence that the amount
determined for reimbursement of medical assistance paid by the department or
county department on behalf of the medical assistance recipient should be
different than set forth in division (G)(2) of section 5160.37 of the Revised
(3) The parties shall
engage in settlement discussions prior to the hearing, as directed by order of
the hearing examiner. The settlement discussions shall occur no later than the
document exchange required under paragraph (D) of rule 5160-80-05 of the
(4) The parties may
provide to the hearing examiner, at least seven calendar days prior to the
hearing, a written statement of their position in the case in lieu of, or
supplemental to, an opening statement.
(5) The appellant and the
department or county department shall, as ordered by the hearing examiner,
prior to hearing exchange all proposed exhibits and other documents to be used
at the hearing.
(6) If an
appellants attorney seeks to have access at the hearing to the
appellants medical assistance information or protected health
information without the appellant being present and the attorney is not acting
in the capacity as an authorized representative, the attorney must present
written authorization signed by the appellant meeting the requirements of
section 5160.45 of the Revised Code.
(7) The appellant and the
department or county department shall have the opportunity to present their
case. The hearing shall be conducted informally, and formal rules of evidence
shall not apply. The parties shall have an adequate opportunity
(a) Present witnesses.
(b) Submit evidence to establish all pertinent facts and
(c) Advance arguments.
(d) Question or refute any testimony or evidence, including
the opportunity to confront and cross-examine adverse witnesses.
(B) The hearing examiner
(1) Hearings shall be
conducted by an impartial department hearing examiner who has no personal stake
or involvement in the case and was not directly involved in the initial
determination being appealed. The hearing examiner shall be under the direction
and supervision of the department.
(2) All orders, reports,
recommendations, and rulings issued by the hearing examiner shall be signed,
dated, and filed with the depository agent. The depository agent shall make
services of those filings on the parties.
(3) The hearing examiner
by order shall direct the parties to engage in settlement discussions and to
report back the results of those discussions.
(4) The hearing examiner
shall have the general authority to regulate the course of the hearing and to
issue orders governing the conduct of the hearing. This includes the authority
(a) Administer oaths or affirmations, order the production
of documents and the attendance of witnesses, call and examine witnesses in a
reasonable and impartial manner, and determine the order in which the
participants in the hearing present testimony and are examined in a manner
consistent with essential fairness and justice.
(b) To rule on the admissibility of evidence, objections,
motions, and to rule on procedural matters.
(c) To take such other actions as might be necessary to
avoid unnecessary delay, prevent presentation of irrelevant or cumulative
evidence, prevent argumentative, repetitious, or irrelevant examination or
cross-examination, and to assure that the hearing proceeds in an orderly and
(5) The hearing examiner,
at his or her discretion, may hold pre-hearing conferences for the purpose of
resolving matters that can be resolved by the parties, including facilitation
of a settlement, identifying the witnesses to be presented and the subjects of
their testimony, discussing possible admissions or stipulations regarding the
authenticity of records, identifying and marking exhibits, ruling on any
procedural motions of the participants in the hearing, and discussing any other
matters deemed appropriate by the hearing examiner for the thorough and
expeditious preparation and disposition of the case.
(6) A party may choose to
present its case entirely in writing provided that a written notice is served
on the other party and hearing examiner no less than fourteen calendar days
before the date scheduled for the hearing. Any party who elects to present the
case entirely in writing must do so in accordance with procedures ordered by
the hearing examiner. In the event that one party elects to present its case
entirely in writing, the other party may elect to present its case entirely in
writing by providing written notice to the hearing examiner and other party no
later than seven calendar days before the date scheduled for the hearing.
Nothing in this rule shall be construed as preventing a party from compelling
the attendance of another party or other witnesses at the hearing or from
questioning the party or other witnesses as if on
(7) The hearing examiner
shall begin the hearing by having the recording equipment started and providing
the following introductory information:
(a) The name and role of the hearing examiner, the case
name, and the appeal number.
(b) How the hearing will be conducted, including the order
of presentation and questioning.
(c) The general time frame within which a decision will be
(d) Who will issue the decision.
(e) How the parties will be notified of the
(f) Where the complete hearing record will be kept after
the decision is issued.
(g) The available appeal rights.
(8) The hearing examiner
shall entertain and rule on any procedural matter prior to opening statements
or the presentation of evidence.
(9) The hearing examiner
shall record the name and role of each person in attendance and shall
administer an oath or affirmation to all who intend to offer
(10) The hearing examiner
shall regulate the order of presentation by the parties. Normally, as the party
with the burden of proof, the appellants presentation will be made
first, subject to questioning by the department or county department and the
hearing examiner, followed by the departments or county
departments presentation, subject to questioning by the appellant and
the hearing examiner. The parties will then be allowed a brief closing
(11) In regulating the
conduct of the hearing, the hearing examiner is responsible for developing the
fullest possible record upon which to base all necessary findings of fact. Each
party shall be treated fairly and impartially and given adequate opportunity to
present its case. The hearing examiner has an affirmative obligation to assist
an unrepresented appellant in understanding the nature of the matters at issue
and how the hearing is to be conducted. The hearing examiner shall take an
active part in questioning the parties and the evidence presented, insofar as
that is necessary to develop the fullest possible record.
(12) After all relevant
testimony and evidence has been presented, the hearing examiner shall determine
whether a sufficient record has been developed upon which to make the decision.
If not, the hearing examiner may order that the hearing be continued to a later
date, permit the issuance of additional subpoenas (if there is a need for
unanticipated, relevant testimony ) or leave the record open for the submission
of additional evidence.
(a) If the hearing is to be continued to a later date, the
hearing examiner shall schedule the continuance at the earliest possible date
and shall formally record the new date and time, as well as the specific
purpose of the continuance. Notification of the parties at the hearing shall be
followed by the issuance of a hearing scheduling notice to the
(b) If the record is to be left open to allow the
submission of additional documentary evidence, the hearing examiner shall
formally record the nature and purpose of the additional evidence and shall
establish the earliest possible realistic deadline for its submission to the
hearing examiner and for response by the parties to that
(c) Additional evidence submitted pursuant to the deadline
shall be forwarded by the party to the opposing party. Evidence submitted after
the deadline may be returned to the submitting party by the hearing examiner
with notice that it will not be used in reaching the decision.
(13) The hearing examiner
shall close the hearing by informing the parties when they can expect the
written decision, adjourning the hearing, and verifying that the recording
equipment is turned off.
(14) All exhibits or
other evidence admitted into the record or proffered shall be filed by the
hearing examiner with the depository agent at the conclusion of the
(15) Following the
hearing, the hearing examiner shall not discuss the substance of the case with
the parties, unless they or their authorized representatives or attorneys