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(a) Within 30 days after receipt of the notice of sanction, the provider may request an appeal, to include a formal hearing. The request for appeal must be in writing and must contain a statement accompanied by supporting documents that describe the asserted violations, discrepancies, or dollar amounts that the provider contends are in compliance with this chapter and the reasons for those contentions. A provider requesting an appeal under this section shall submit the request to the commissioner.
(b) Upon receipt of the request for appeal, the withholding or suspension of payment may continue until a final determination is made regarding the appropriateness of the sanction.
(c) Unless a timely and proper request for appeal is received by the division the findings of the notice of sanction are considered a final and binding administrative determination.
(d) No formal review will be granted if the basis for termination is a failure to meet standards (including licensure or registration) required by federal or state law for participation in the medicaid program.
(e) Any party may appear and be heard at any proceeding through an attorney at law or through a designated representative.
(f) Upon receipt of the request for appeal, a hearing must be scheduled to be held within 30 days of receipt of the request. Notice of the date, time, and place of the hearing must be sent to the provider and his attorney or representative.
(g) Repealed 6/19/2004.
History: Eff. 8/18/79, Register 71; readopt 8/7/96, Register 139; am 6/19/2004, Register 170
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.980 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.
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Last modified 7/05/2006