Sec. 10.09.22.08. Cause for Suspension or Removal and Imposition of Sanctions

A. If the Department determines that a provider, any agent or employee of a provider, or any person with an ownership interest in the provider, has failed to comply with all applicable federal or State laws or regulations, the Department may initiate one or more of the following actions against the responsible party:

(1) Recovery of overpayments as specified in Regulation .07 of this chapter;

(2) Withholding part or all of the payment by the Program;

(3) Suspension from the Program;

(4) Permanent removal from the Program;

(5) Disqualification from future participation in the Program, either as a provider or as a person providing services for which Program payment will be claimed.

B. If the Secretary of Health and Human Services suspends or removes the provider from participation in Medicare, the Department will take similar action.

C. The Department shall give to the provider reasonable written notice of its intention to impose sanctions. In the notice, the Department shall:

(1) Establish the:

(a) Effective date of the proposed action; and

(b) Reasons for the proposed action; and

(2) Advise the provider of the right to appeal.