7 AAC 43.960. Imposition of sanction

(a) The decision as to the sanction to be imposed will be at the discretion of the director of the division except as provided in (c) of this section.

(b) The following factors will be considered 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 division will, in its discretion, initiate proceedings to terminate a provider from the medicaid program, if a provider or an employee of the provider has been

(1) convicted of defrauding the medicaid program

(2) convicted of a crime that causes the division to consider the provider as posing a health or safety risk to a recipient;

(3) previously suspended under 7 AAC 43.950 due to program abuse or abuse of a recipient; or

(4) terminated from the medicare program for abuse.

History: Eff. 8/18/79, Register 71; am 6/27/92, Register 122; readopt 8/7/96, Register 139

Authority: AS 47.05.010

AS 47.07.030

AS 47.07.050

Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.960 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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