Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 150 - Prospective Payment System; Other Payment
7 AAC 150.220 - Administrative appeal

Universal Citation: 7 AK Admin Code 7 AAC 150.220

Current through February 27, 2024

(a) Not later than 30 days after a written determination under 7 AAC 150.210(a) is mailed or electronically delivered to a facility, a facility aggrieved by that determination may request reconsideration under 7 AAC 150.210(b) or may file a written notice of appeal with the commissioner. In the notice of appeal, the facility must

(1) set out a statement of issues;

(2) identify the basis for the facility's contention that the written determination of the prospective payment rate is incorrect;

(3) specify the relief requested;

(4) provide a name, address, telephone number, and other contact information for the facility representative designated as the point of contact for the appeal; and

(5) include a certificate showing the date the appeal was mailed or electronically delivered.

(b) If a request for reconsideration under 7 AAC 150.210(b) is denied, or if a facility is aggrieved by a decision on reconsideration under 7 AAC 150.210(b), the facility may file a written notice of appeal with the commissioner not later than 30 days after the date the denial or decision is mailed or electronically delivered. In the notice of appeal, the facility must

(1) set out a statement of issues;

(2) identify the basis for the facility's contention that the written determination of the prospective payment rate is incorrect;

(3) specify the relief requested;

(4) provide a name, address, telephone number, and other contact information for the facility representative designated as the point of contact for the appeal; and

(5) include a certificate showing the date the appeal was mailed or electronically delivered.

(c) If a decision on a prospective payment rate is appealed to the commissioner, that rate will be effective subject to adjustment based on the commissioner's decision on the administrative appeal.

(d) A notice of appeal under (a) or (b) of this section must be filed at the office of the commissioner in Juneau, and a copy must be sent to the Anchorage office of the department with the staff that oversees Medicaid payment rates.

(e) The commissioner will deny an administrative appeal as untimely if not filed within the time limits set out in this section.

The address for filing of the original of a notice of appeal under 7 AAC 150.220(a) or (b) is Office of the Commissioner, Room 229, Alaska Office Building, P.O. Box 110601, Juneau, Alaska 99811-0601. The address for sending a request for reconsideration, or for sending copies described in 7 AAC 150.220(d) is Department of Health and Social Services, Office of Rate Review, 3601 C Street, Suite 978, Anchorage, Alaska 99503.

Authority: AS 47.05.010

AS 47.07.070

AS 47.07.075

Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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