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The following sanctions may be invoked against providers based on the grounds specified in 7 AAC 43.950:
(1) termination from participation in the medicaid program;
(2) suspension of participation in the medicaid program;
(3) suspension or withholding of payments to a provider;
(4) referral to a utilization and quality control peer review organization;
(5) transfer to a closed-end provider agreement not to exceed 12 months or the shortening of an already existing closed-end provider agreement;
(6) attendance at provider education sessions;
(7) prior authorization of services;
(8) 100 percent review of the provider's claims before payment;
(9) referral to the state licensing board for investigation;
(10) recoupment of overpayments;
(11) public notice of suspension or termination of a provider.
History: Eff. 8/18/79, Register 71; am 6/27/92, Register 122; readopt 8/7/96, Register 139; am 11/1/2000, Register 156
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.955 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