Nebraska Statutes 44-32,157. Hearing; notice; decision; appeal
(1) If the health maintenance organization or applicant requests a hearing pursuant to section 44-32,156, the Director of Insurance shall issue a written notice of hearing and send it to the health maintenance organization or applicant by certified or registered mail and to the Department of Health and Human Services stating:
Terms Used In Nebraska Statutes 44-32,157
- Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
- Director: shall mean the Director of Insurance. See Nebraska Statutes 44-3298
- Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105
(a) A specific time for the hearing, which may not be less than twenty nor more than thirty days after mailing of the notice of hearing; and
(b) A specific place for the hearing, which may be either in Lancaster County or in the county where the health maintenance organization’s or applicant’s principal place of business is located.
(2) If a hearing is requested, the chief executive officer of the Department of Health and Human Services or his or her designated representative shall be in attendance and shall participate in the proceedings. The recommendations and findings of the chief executive officer with respect to matters relating to the quality of health care services provided in connection with any decision regarding denial, suspension, or revocation of a certificate of authority shall be conclusive and binding upon the Director of Insurance.
(3) After the hearing or upon failure of the health maintenance organization to appear at such hearing, the Director of Insurance shall take whatever action he or she deems necessary based on written findings and shall mail his or her decision to the health maintenance organization or applicant with a copy to the Department of Health and Human Services. The action of the Director of Insurance and the recommendation and findings of the chief executive officer may be appealed, and the appeal shall be in accordance with the Administrative Procedure Act. The act shall apply to proceedings under this section to the extent it is not in conflict with this section.