7-01 Appeals Policy Overview

7.01 Appeals Policy Overview

Effective Date: 08/01/2021

PURPOSE:    

To provide an overview of the Vendor appeal process and explain the distinction between administrative reviews and administrative hearings.

DEFINITIONS:

Administrative hearing means a formal appeal process that provides Vendors the opportunity to present evidence before an impartial hearing officer.

Administrative review means an informal review of Department documentation and Vendor-submitted information conducted by Department staff who were not involved in the original adverse action.

Appeal means a Vendor request for review of an adverse action taken by the Department.

Adverse action means an administrative action taken against a Vendor that negatively affects the Vendor’s participation in the WIC Program.

POLICY:

1. The Department shall provide Vendors an opportunity to appeal certain adverse actions in accordance with Federal WIC regulations.

    

2. Vendor appeals are divided into two categories:

    

   1. Administrative reviews; and

       

   2. Administrative hearings.

    

3. The Department shall notify Vendors in writing when an adverse action includes appeal rights.

    

4. The written notice shall include:

    

   1. The reason for the adverse action;

       

   2. The effective date of the action;

       

   3. The applicable appeal process;

       

   4. Instructions for requesting an appeal; and

       

   5. The deadline for submitting an appeal request.

    

5. Vendors must submit appeal requests within the timeframe identified in the notice of adverse action.

    

6. Failure to request an appeal within the required timeframe results in waiver of appeal rights.

    

7. Some adverse actions are not subject to appeal under Federal WIC regulations. (See Policy 7.02 Adverse Actions Subject to Appeal.)

References:

7 CFR Part 246.18

Cross-References:

6.03 Adverse Actions Against Vendors

7.02 Adverse Actions Subject to Appeal

7.03 Administrative Reviews

7.04 Administrative Hearings