10 Colo. Code Regs. § 2505-10-8.130.80
Current through Register Vol. 47, No. 11, June 10, 2024
Section 10 CCR 2505-10-8.130.80 - INACTIVATING PROVIDER AGREEMENTSA. A Provider may have its Provider Participation Agreement inactivated and will no longer be able to bill for goods and services if any of the following occur: 1. The Provider's license, certification, or accreditation has expired or is subject to conditions or restrictions. 2. The Provider has failed to complete Provider revalidation. 3. The Provider is no longer eligible to participate as a Medical Assistance Program Provider or breaches the Provider agreement. 4. There is a Change of Ownership. 5. The Provider's business closes, or the business is nonoperational. 6. The Provider is deceased or retired. 7. The Provider is inactive and has not submitted any claims activity for 24 months.B. The Provider will be sent written notice thirty (30) days prior to the inactivation, unless otherwise required by federal or state statute, regulation, or rule. 1. The notice will detail the reason for the inactivation.2. The notice will give the Provider the opportunity to dispute the inactivation. C. If the Provider elects to dispute the inactivation, the Department must receive the Provider's written request to dispute the inactivation within thirty (30) calendar days of the date of the inactivation notice.D. The Department will review the request and issue a determination on the inactivation which will include the Provider's right to file an appeal in accordance with Section 8.050.E. The effective date of the inactivation may be backdated to the date of the occurrence described in Section 8.130.80.A.44 CR 23, December 10, 2021, effective 1/10/2022