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(a) A sanction may be applied to all known affiliates of a provider; however, each decision to include an affiliate must be made on a case-by-case basis after giving due regard to all relevant facts and circumstances. The violation, failure, or inadequacy of performance may be imputed to a person with whom the provider is affiliated where the conduct was accomplished within the course of his or her official duty or was effectuated by him or her with the knowledge or approval of the provider.
(b) Suspension or termination from participation of any provider will preclude the provider from submitting claims for payment, either personally or through claims submitted by any clinic, group, corporation, or other association to the division or its fiscal agents for any services or supplies provided before the suspension or termination.
(c) A clinic, group, corporation or other association which is a provider of services may not submit payment claims to the division or its fiscal agents for any services or supplies provided by a person within that organization who has been suspended or terminated from participation in the medicaid program, except for those services or supplies provided before the suspension or termination.
(d) When the provisions of (c) of this section are violated by a provider of services which is a clinic, group, corporation or other association, the division may suspend or terminate the organization or any individual person within it who is responsible for the violation, or both.
History: Eff. 8/18/79, Register 71; readopt 8/7/96, Register 139
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.965 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