Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 105 - Medicaid Provider and Recipient Participation
Article 2 - Provider Enrollment, Rights, and Responsibilities
7 AAC 105.280 - Second-level provider appeal

(a) A provider may appeal a first-level appeal decision under 7 AAC 105.270(a) - (f) if the provider submits a written request to the department no later than 60 days after the date of the first-level appeal decision.

(b) A provider that appeals a first-level appeal decision under this section shall

(c) The department will not consider an appeal under this section that is submitted after the date that the appeal must be submitted.

(d) In an appeal by a provider under this subsection of a decision that was denied because the provider failed to timely file a claim, the department will

(e) A decision by the department under this section is a final administrative decision, and the department will notify the provider of the provider's right to appeal to the superior court under the Alaska Rules of Appellate Procedure.

(f) The provisions of this section do not apply to recoupment actions resulting from audits conducted under 7 AAC 160.100 - 7 AAC 160.130.

(g) Repealed 8/1/2020.

(h) The department will find good cause for a provider's failure to submit a claim before the billing deadline under 7 AAC 145.005(c) if the failure to submit the claim resulted from a condition that was beyond the provider's control or was caused by a condition that the provider could not reasonably be expected to prevent. In this subsection, a condition beyond the provider's control or a condition that the provider could not reasonably be expected to prevent