7-02 Adverse Actions Subject to Appeal

7.02 Adverse Actions Subject to Appeal

Effective Date: 08/01/2021

PURPOSE:    

To identify which adverse actions are subject to appeal and the type of appeal available.

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.

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 the opportunity to request either an administrative review or an administrative hearing for specific adverse actions.

    

2. The following adverse actions are subject to an administrative review:

    

   1. Denial of authorization based on Vendor selection criteria;

       

   2. Termination based on failure to meet Vendor selection criteria;

       

   3. Denial based on the Vendor Limitation Policy;

       

   4. Claims against Vendors; and

       

   5. Other actions identified by the Department as eligible for administrative review.

    

3. The following adverse actions are subject to an administrative hearing:

    

   1. Disqualification;

       

   2. Civil money penalties;

       

   3. Termination based on Vendor violations; and

       

   4. Other actions identified by Federal regulation as requiring an administrative hearing.

    

4. The following actions are not subject to appeal:

    

   1. The validity or appropriateness of Federal statutes or regulations;

       

   2. The validity or appropriateness of Department policies required by Federal regulation;

       

   3. Expiration of a Vendor Contract;

       

   4. Vendor peer group assignments and criteria;

       

   5. The Department’s Vendor ranking and selection process under the Vendor Limitation Policy; or

       

   6. Denial of authorization because no Vendor openings exist.

    

5. Appeal requests must be submitted within the timeframe identified in the notice of adverse action.

References:

7 CFR Part 246.18

Cross-References:

2.04 Vendor Limitation Policy

6.02 Claims Against Vendors

6.03 Adverse Actions Against Vendors

7.01 Appeals Policy Overview

7.03 Administrative Reviews

7.04 Administrative Hearings