What's happening
The bill allows aggrieved parties in social services appeals an additional option to seek review by a supervising administrative law judge before pursuing court action.
Why it matters
Creates an additional, potentially faster and less costly step before court. By allowing parties to seek review by a supervising administrative law judge, the bill gives people a way to resolve disputes within the agency hierarchy before having to go through the complexities and expenses of a court case.
May lead to more consistent and expert decisions. Supervising administrative law judges, or designees of the commissioner, are likely to have specialized knowledge of social services law and policy, possibly resulting in more uniform and informed decisions for appeals.
Could reduce the burden on courts. If more disputes are resolved at this new review level, fewer cases may proceed to court, freeing up judicial resources and potentially speeding up resolution for those that do need judicial intervention.
Empowers aggrieved parties with procedural choice. Individuals and social services officials now have more flexibility in how they challenge decisions they believe are wrong, which could lead to fairer outcomes and greater satisfaction with the process.
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Who cares
Headline styles
Expand Fair Hearing Appeals
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to social services
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8758
IN SENATE
May 11, 2018
Introduced by Sen. HANNON -- (at request of the Medicaid Inspector General) -- read twice and ordered printed, and when printed to be committed to the Committee on Social Services
AN ACT to amend the social services law, in relation to appeals and fair hearings
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph (b) of subdivision 9 of section 22 of the social services law, as added by chapter 473 of the laws of 1978, is amended to read as follows:
(b) Any aggrieved party to an appeal, including a social services official provided an application by any such social services official has not been determined by any federal agency to be in violation of federal law, may either: (i) apply to the department's supervising administrative law judge, or such other individual as the commissioner may designate, for review as provided in department regulations; or (ii) apply for review as provided in article seventy-eight of the civil practice law and rules.
§ 2. This act shall take effect on the ninetieth day after it shall have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14368-01-8
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to appeals and fair hearings
Purpose of the bill
This bill would amend the Social Services Law (SSL) to permit any party in a Department of Health (DOH) administrative hearing to appeal the final determination to DOH's chief Administrative Law Judge (ALJ).
Summary of provisions
Section one of the bill would amend subdivision 9 of SSL § 22 to allow any party to appeal the final determination of the presiding ALJ to DOH's chief ALJ.
Section two of the bill would make it effective 90 days after it shall become law.
Justification
There is a right to fairness in adjudicatory proceedings for all parties involved. When making a determination in an administrative proceeding, the presiding ALJ is required to set forth the grounds for the decision and the essential facts upon which the agency's inferences are based. Such a determination is required to be supported by a substantial weight of the evidence and grounded in law. Currently, if the presiding AU errs in making a decision, the appellant has the right to apply for a review of such determination as provided by article seventy-eight of the Civil Practice Law and Rules. However, if an error is made by the All against the agency, there is arguably no recourse to the agency. An erroneous decision could have a significant effect on the agency's ability to pursue future claims, implement sanctions, or recover overpayments for claims rightfully due to the State. This bill would create a mechanism for either party to appeal to the Chief Administrative Law Judge or such other person designated by the Commissioner of Health for a review of the determination made by the presiding ALJ.
The Medicaid Inspector General's inability to appeal an adverse deci- sion, is inconsistent with the right to appeal afforded to other State agencies such as the Industrial Board of Appeals and the Unemployment Insurance Appeals Board. The creation of this mechanism allows any aggrieved party, including the Medicaid Inspector General's Office, the right to fully explain the facts and law on which it relied and the error made by the presiding ALJ. Appealing to the Chief ALJ is a less costly method of review for all parties involved and may result in potential errors being corrected prior to the commencement of a timely and costly article seventy-eight action.
Prior legislative history
None.
Fiscal implications
This bill is likely to have a positive impact on the State. Creating a mechanism of review available to either party establishes a more balanced set of litigation risks, leading to some reduction in the volume of litigation. Reduced litigation creates the potential for reduced costs and improved voluntary compliance. Correction of errors may also lead to increased recoveries.
Effective date
The bill would take effect 90 days after it becomes law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.