Current through Register Vol. 54, No. 25, June 22, 2024
Section 52.62 - Prohibition of services(a) A provider may be sanctioned, prohibited or disenrolled from providing services for failure to perform any of the following: (1) Protect the health and welfare of a participant during service delivery.(2) Comply with applicable Federal or State laws and this chapter.(3) Comply with a provision of the MA provider agreement, including the waiver addendum.(4) Deliver a service in the type, scope, amount, duration and frequency required by the approved service plan when the participant is available for the delivery of the service.(5) Develop or implement a CAP.(6) Maintain licenses or certifications, or both, as required by Federal or State agencies.(7) Maintain accurate records.(b) The Department may prohibit a provider from providing new participants with services if the provider violates subsection (a).(c) A disenrolled provider shall cooperate with the Department, new providers of services and participants with transition planning to ensure participant's continuity of care.