Washington Administrative Code

(1) The administrative law judge (ALJ) must hear and decide the issues de novo (anew) based on the evidence presented and admitted into the record during the hearing.(2) As needed, the ALJ may:(a) Determine the order for presenting evidence;(b) Issue subpoenas or orders directing…

(1) The authority of the administrative law judge and the review judge is limited to those powers granted by statute or rule. The ALJ and the review judge do not have any inherent or common law powers. (2) Neither an administrative law judge nor a review judge may decide that a r…

(1) A review judge has the same authority and responsibilities as an administrative law judge, as described in WAC 182-526-0215, when conducting a hearing.(2) A review judge conducts the hearing and enters the final order in cases where a contractor for the delivery of nursing fa…

(1) Administrative law judges (ALJs) and review judges must first apply the applicable program rules adopted in the Washington Administrative Code (WAC). (2) If no program rule applies, the ALJ and review judge must decide the issue according to the best legal authority and reaso…

(1) A final order may be relied on, used, or cited as precedent by a party if the final order has been indexed in the index of significant decisions maintained by the health care authority (HCA).(2) The index of significant decisions is available to the public at http://www.hca.w…

(1) The office of administrative hearings (OAH) assigns an administrative law judge (ALJ) at least five business days before the hearing, except when the hearing is expedited.(2) A party may ask which ALJ is assigned to the hearing by calling or writing to the OAH field office li…

(1) A party requesting a different administrative law judge (ALJ) may do so by filing a written motion of prejudice consistent with RCW 34.12.050. A party must file the motion with the office of administrative hearings (OAH) before the ALJ rules on a discretionary issue in the ca…

(1) An administrative law judge (ALJ) or review judge may be disqualified for bias, prejudice, or conflict of interest, or if one of the parties or a party's representative has ex parte contact with the ALJ or review judge.(2) Ex parte contact means any written or oral communicat…

(1) The office of administrative hearings (OAH) must serve a notice of hearing on all parties and their representatives at least fourteen calendar days before the hearing date. (2) If OAH schedules a prehearing conference, OAH must serve a notice of prehearing conference to the p…

(1)(a) A notice of hearing or a notice of prehearing conference is a written notice issued by the office of administrative hearings (OAH) that must include the:(i) Names of all parties to whom the notice is sent and, if known, the names and addresses of their representatives;(ii)…

(1) The administrative law judge (ALJ) must allow the health care authority (HCA), HCA's authorized agent, or a managed care organization (MCO) to amend (change) the notice of an action before or during the hearing to match the evidence and facts.(2) HCA, HCA's authorized agent, …

(1) The administrative law judge (ALJ) may allow the party that requested the hearing to amend its hearing request before or during the hearing.(2) The ALJ must offer to continue (postpone) the hearing to give the other parties more time to prepare or present evidence or argument…

(1) The appellant must tell the health care authority (HCA) hearing representative and the office of administrative hearings (OAH) as soon as possible, when the party's mailing address changes.(2) If a party does not notify the HCA hearing representative and OAH of a change of ma…

(1) Any party may request a continuance under this section either orally or in writing.(2) Before contacting the office of administrative hearings (OAH) to request a continuance, the party seeking the continuance must make a good faith effort to contact the other parties to find …

This section applies to continuance requests made in provider hearings, estate recovery hearings, or nursing home rate hearings.(1) A request for continuance under this section may be made either orally or in writing.(2) Before contacting the office of administrative hearings (OA…

(1) An order of default may be entered when the appellant fails to attend a scheduled prehearing conference or hearing. The order of default will include a notice of inquiry as to whether the appellant wants to petition to reinstate the hearing.(2) The appellant may file a petiti…

(1) An order of dismissal may be entered when the appellant withdraws the request for hearing under WAC 182-526-0115. (2) An appellant may file a petition (request) to vacate an order of dismissal under WAC 182-526-0290.(3) An order of dismissal becomes a final order by operation…

(1) If an order of default was entered under WAC 182-526-0284, or an order of dismissal was entered under WAC 182-526-0285, the appellant may file a petition (request) to vacate (set aside) the order.(a) If the order was issued by the office of administrative hearings (OAH), the …

An order of dismissal issued based on lack of subject matter jurisdiction must be entered as an initial order subject to the requirements of WAC 182-526-0520.[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 17-05-066, § 182-526-0300, filed 2/13/17, effective 3/16/17.]

A party may request that an administrative law judge (ALJ) or review judge stay (stop) a health care authority action until there is a decision entered by the ALJ or review judge. The ALJ or review judge decides whether to grant or deny the stay and enters a written order.[Statut…

(1) An administrative law judge (ALJ), the health care authority hearing representative, and an attorney for a party may issue subpoenas. If a party is not represented by an attorney, that party may ask the ALJ to issue a subpoena on the party's behalf. The ALJ may schedule a pre…

(1) The office of administrative hearings (OAH) may schedule a hearing to be conducted in-person, by telephone, or by video.(2) A telephonic or video hearing is where the appellant appears by telephone, video, or other electronic means.(3) An in-person hearing is where the appell…

(1) If the hearing is scheduled as an in-person hearing, an administrative law judge (ALJ) is physically present.(2) If the hearing is scheduled as a telephonic hearing, an ALJ is present by telephone.[Statutory Authority: 2011 1st sp.s. c 15 § 53, chapters 74.09, 34.05 RCW, and …

The administrative law judge must make an audio record of the entire hearing.[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 17-05-066, § 182-526-0350, filed 2/13/17, effective 3/16/17. Statutory Authority: 2011 1st sp.s. c 15 § 53, chapters 74.09, 34.05 RCW, and 10-08 WAC…

(1) All parties and their representatives may attend a hearing under this chapter.(2) Witnesses may be excluded from the hearing if the administrative law judge (ALJ) finds good cause to do so.(3) The ALJ may also exclude other people from all or part of the hearing.[Statutory Au…

(1) For cases in which the party who requested a hearing is an applicant or recipient of a medical services program administered by the agency, the hearing must be held according to RCW 74.09.741 (5)(c).(2) An applicant or recipient may agree to have one or more prehearing confer…

(1) When a hearing is conducted by telephone, an administrative law judge (ALJ) may order the parties to file and serve any documents or proposed exhibits at least five days before the hearing.(2) The health care authority hearing representative may be able to help a party copy a…

At a hearing under this chapter: (1) The administrative law judge (ALJ): (a) Explains the hearing rights of the parties;(b) Marks and admits or rejects exhibits;(c) Ensures that a record is made;(d) Explains that a decision is mailed after the hearing;(e) Notifies the parties of …

(1) A group hearing may be held when two or more parties request a hearing about similar issues. (2) Hearings may be combined at the request of the parties or the administrative law judge (ALJ).(3) All parties participating in a group hearing may have their own representative pre…

(1) The following requirements apply only to hearings in which an applicant or recipient of medical services programs administered by the agency seeks review of decisions made by more than one agency, as defined in RCW 34.05.010. For example: A medical services program recipient …

(1) Evidence includes documents, objects, and testimony of witnesses that parties offer during the hearing to help prove their positions.(2) Evidence may be all or parts of original documents and may be copies of the originals.(3) Parties may offer statements signed by a witness …

(1) A stipulation is an agreement among two or more parties that certain facts or evidence is correct or authentic.(2) If an administrative law judge (ALJ) accepts a stipulation, the ALJ must enter it into the record.(3) A stipulation may be made before or during the hearing.(4) …

(1) Proposed exhibits.(a) Proposed exhibits are documents or other objects that a party wants the administrative law judge (ALJ) to consider when reaching a decision.(b) After the document or object is accepted by the ALJ, it is admitted and becomes an exhibit.(2) Marking and num…

(1) The administrative law judge (ALJ) may consider and admit evidence by taking judicial notice.(2) Judicial notice is evidence that includes facts or standards that are generally recognized and accepted by judges, government agencies, or national associations. For example, an a…

(1) The following persons may be witnesses in a hearing:(a) The appellant or the health care authority (HCA) hearing representative; or(b) Anyone the parties or the administrative law judge (ALJ) asks to be a witness.(2) The ALJ decides who may testify as a witness.(3) An expert …

(1) Burden of proof is a party's responsibility to:(a) Provide evidence regarding disputed facts; and(b) Persuade the administrative law judge (ALJ) that a position is correct.(2) To persuade the ALJ, the party who has the burden of proof must provide the amount of evidence requi…

Standard of proof refers to the amount of evidence needed to prove a party's position. Unless the rules or law states otherwise, the standard of proof in a hearing is a preponderance of the evidence. This standard means that it is more likely than not that something happened or e…

(1) Equitable estoppel is a legal doctrine that may be used only as an affirmative defense to prevent the health care authority (HCA) from collecting an overpayment. Equitable estoppel may not be used to require HCA to continue to provide something or to require HCA to take actio…

(1) Before the record is closed, the administrative law judge (ALJ) may:(a) Set another hearing date;(b) If needed, enter orders addressing limited issues before issuing a hearing decision resolving all issues in the proceeding; or(c) Give the parties more time to file exhibits o…

(1) The administrative law judge must produce a complete official record of the proceedings.(2) The official record must include, if applicable:(a) Notice of all proceedings;(b) Any prehearing order;(c) Any motions, pleadings, briefs, petitions requests, and intermediate rulings;…

In an initial order, the administrative law judge (ALJ) must:(1) Identify the matter as a health care authority appeal;(2) List the name and docket number of the case and the names of all parties and representatives;(3) Make findings concerning the facts used to resolve the dispu…

An initial order becomes a final order at 5:00 p.m. on the twenty-first calendar day after the office of administrative hearings (OAH) serves the initial order, unless:(1) Any party files a request for review of the initial order within twenty-one calendar days of the serving (ma…

(1) If a party disagrees with an administrative law judge's (ALJ) initial order because of a clerical error, the party may ask for a corrected initial order from the ALJ as provided in WAC 182-526-0540 through 182-526-0555.(2) If a party disagrees with an initial order for a reas…

(1) A clerical error is a mistake that does not change the intent of the initial order.(2) The administrative law judge (ALJ) may correct clerical errors in the initial order by entering a corrected initial order. The ALJ may correct clerical errors in response to a request by on…

(1) A party may request that the administrative law judge (ALJ) issue a corrected initial order by calling or writing to the office of administrative hearings field office that held the hearing.(2) When asking for a corrected initial order, the party must identify the clerical er…

(1) A party requesting a corrected initial order from the administrative law judge (ALJ) must make the request on or before the tenth calendar day after the order was served.(2) The time period provided in subsection (1) of this section and the time it takes the ALJ to deny the r…

(1) When a party requests a corrected initial order, the administrative law judge (ALJ) must either:(a) Serve all parties a corrected order within ten calendar days; or(b) Deny the request in writing within three business days of receiving it.(2) If the ALJ corrects an initial or…

(1) A party who disagrees with the initial order entered by an administrative law judge (ALJ) may request review by a review judge at the board of appeals (BOA).(2) When a review judge reviews an initial order, the review judge does not hold another hearing. See WAC 182-526-0595.…

(1) The review judge, in most cases, only considers evidence admitted in the record by the administrative law judge.(2) The review judge considers the request, the initial order, and the record before deciding if the initial order should be changed. (3) The review judge may allow…

(1) Any party may request a review judge to review the initial order.(2) If more than one party requests review, each request must meet the deadlines in WAC 182-526-0580.[Statutory Authority: 2011 1st sp.s. c 15 § 53, chapters 74.09, 34.05 RCW, and 10-08 WAC. WSR 13-02-007, § 182…