7 Alaska Admin. Code § 105.440

Current through May 31, 2024

Section 7 AAC 105.440 - Notice of sanction

(a) When the department determines that a sanction against a provider is warranted under 7 AAC 105.400 - 7 AAC 105.420, the department will send written notice of the determination to the provider by certified mail. In the notice, the department will include

(1) the grounds for sanction under 7 AAC 105.400, including all relevant facts;

(2) the proposed sanction to be imposed by the department under 7 AAC 105.410 - 7 AAC 105.420;

(3) whether the matter has been referred for fiscal audit under 7 AAC 160.110;

(4) any action required of the provider; and

(5) the provider's right to an appeal under 7 AAC 105.460.

(b) The proposed sanction is effective 30 days after the date on the notice if the provider does not request an appeal or submit the information required under 7 AAC 105.460 30 days or less after the date on the notice or 30 days after the date of the final administrative appeal decision upholding the proposed sanction. A proposed immediate suspension issued under 7 AAC 160.140 of a provider's participation in the Medicaid program is effective 10 days after the date on the notice.

(c) In addition to the notice under (a) of this section, the department will notify a provider's known professional societies, the Department of Commerce, Community, and Economic Development, and any other federal or state agency that the department is aware has an interest. In the notification, the department will include the findings made by the department, the sanction imposed, and the date the sanction will begin.

(d) If a provider's participation in the Medicaid program has been suspended or terminated, the department will send written notice of that sanction to each recipient for whom the provider has submitted a claim for a service provided in the 12 months preceding the date of the notice of sanction. The department will send the written notice to the last mailing address of the recipient known to the department. The department will also publish notice of the sanction in a newspaper of general circulation or use another method of posting or publication.

7 AAC 105.440

Eff. 2/1/2010, Register 193

Authority:AS 47.05.010

AS 47.07.040