Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 160 - Medicaid Program; General Provisions
Article 1 - Program Integrity and Quality Assurance
7 AAC 160.130 - Appeal

(a) A provider may appeal the findings of a final audit conducted under 7 AAC 160.110 and determinations of overpayment amount under the audit. A provider may requeste reconsideration of the audit findings before a formal appeal. If a provider requests reconsideration, the provider may still request a formal appeal under this section by requesting the appeal not later than 30 days after the date of the notice of decision on reconsideration.

(b) An appeal under this section must

(c) The department will refer an appeal received under this section to the Department of Administration, office of administrative hearings (AS 44.64.010). At the hearing under AS 44.64.060, the department must prove by a preponderance of the evidence to the administrative law judge that overpayments were properly identified and that the amount is correctly calculated. The commissioner will render a decision on an appeal after reviewing, under AS 04.64.060(e), the record and the proposed decision submitted under AS 44.64.060(d) by the administrative law judge.

(d) The commissioner's decision under this section is a final administrative decision. The department will notify the provider of the provider's right to appeal the final administrative decision to the superior court under the Alaska Rules of Appellate Procedure.