Tran v. State


Nebraska Supreme Court Online Library www.nebraska.gov/apps-courts-epub/ 05/03/2019 08:06 AM CDT -1- Nebraska Supreme Court A dvance Sheets 303 Nebraska R eports TRAN v. STATE Cite as 303 Neb. 1 A nn Tran, appellant, v. State of Nebraska and Nebraska Department of H ealth and Human Services, Division of Medicaid and Long -Term Care, appellees. ___ N.W.2d ___ Filed May 3, 2019. No. S-17-1303. 1. Administrative Law: Judgments: Appeal and Error. A judgment or final order rendered by a district court in a judicial review pursuant to the Administrative Procedure Act may be reversed, vacated, or modified by an appellate court for errors appearing on the record. 2. ____: ____: ____. When reviewing an order of a district court under the Administrative Procedure Act for errors appearing on the record, the inquiry is whether the decision conforms to the law, is supported by com- petent evidence, and is neither arbitrary, capricious, nor unreasonable. 3. Judgments: Appeal and Error. An appellate court, in reviewing a dis- trict court’s judgment for errors appearing on the record, will not substi- tute its factual findings for those of the district court where competent evidence supports those findings. 4. Administrative Law: Statutes. Agency regulations properly adopted and filed with the Secretary of State of Nebraska have the effect of statutory law. 5. Statutes: Appeal and Error. Statutory language is to be given its plain and ordinary meaning, and an appellate court will not resort to inter- pretation to ascertain the meaning of statutory words which are plain, direct, and unambiguous. 6. Administrative Law: Presumptions: Proof. When challenging the decision of an administrative agency, the presumption under Nebraska law is that the agency’s decision was correct, with the burden of proof upon the party challenging the agency’s actions. 7. Administrative Law: Medical Assistance. The Department of Health and Human Services may impose sanctions against a Medicaid service provider for (1) presenting any false claim for services for payment, -2- Nebraska Supreme Court A dvance Sheets 303 Nebraska R eports TRAN v. STATE Cite as 303 Neb. 1 (2) failing to make available to the department records of services pro- vided to Medicaid clients when requested, and (3) breaching the terms of the Medicaid provider agreement. 8. ____: ____. Sanctions available to the Department of Health and Human Services for a Medicaid service provider violation include termination from the Medicaid program, suspension or withholding of payments, recoupment from future payments, or provider education. 9. ____: ____. The decision of the sanction to be imposed for a Medicaid service provider violation is left to the discretion of the director of the Department of Health and Human Services. 10. ____: ____. The director of the Department of Health and Human Services considers the following factors in determining an appropriate sanction for a Medicaid service provider violation: (1) seriousness of the offenses, (2) extent of violations, (3) history of prior violations, (4) prior imposition of sanctions, (5) prior provision of provider education, (6) provider willingness to comply with program rules, (7) ...

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