Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 105 - Medicaid Provider and Recipient Participation
Article 3 - Provider Sanctions and Remedies
7 AAC 105.420 - Imposition of sanction
Universal Citation: 7 AK Admin Code 105.420
Current through November 28, 2024
(a) Except as provided under (c) of this section, if one or more grounds for sanction exist under 7 AAC 105.400, the department will determine which sanction to impose under 7 AAC 105.410.
(b) The department will consider the following factors in determining the sanction to be imposed:
(1) seriousness of the offense;
(2) extent of violations;
(3) history of prior violations;
(4) prior imposition of sanctions;
(5) prior provision of provider
education;
(6) provider willingness
to obey program rules;
(7) whether
a lesser sanction will be sufficient to remedy the problem; and
(8) actions taken or recommended by
peer-review groups or licensing boards.
(c) The department will initiate proceedings to suspend or terminate a provider from the Medicaid program under 7 AAC 105.410, if a provider or an employee of the provider has
(1) been convicted of medical
assistance fraud under
AS
47.05.210;
(2) been convicted of a crime the department
considers a risk to the health or safety of a recipient, including a barrier
crime under
7
AAC 10.905;
(3) been previously suspended under
7
AAC 105.410 due to program abuse or abuse of a
recipient;
(4) violated
7
AAC 105.430(c); or
(5) terminated from the Medicare program for
fraud or abuse of the Medicare program.
Authority:AS 47.05.010
AS 47.07.040
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