7 AAC 165.050 - Program standards for continuing participation
(a) A provider who
has received an incentive payment under this chapter must continue to meet the
eligibility standards for that payment through the entire payment
year.
(b) The department may
investigate a provider and audit the provider's records to verify that the
provider
(1) continues to be enrolled and in
compliance with the Medicaid program under 7 AAC 105 - 7 AAC 160;
(2) continues to meet the requirements of
this chapter, including
(A) the accurate
calculation and reporting of Medicaid patient volume, needy individual patient
volume, and total patient volume for the type of provider, in accordance with
42 C.F.R.
495.302 -
495.306, adopted by reference in
7
AAC 165.010(b) (1); and
(B) in each participation year after the
provider's initial year of participation, meaningful use objectives and
measures applicable to the type of provider that are established in 42 C.F.R.
495.6, adopted by reference in
7
AAC 165.020(c) (2);
(3) received accurate payments;
and
(c) An investigation or audit conducted under
(b) of this section may include any information the provider used to justify
payment under this chapter, including the results of any Medicaid claim or
payment information generated under 7 AAC 105 - 7 AAC 160.
(d) If the department finds that a provider
is deficient for any reason listed in (b) of this section, the department may
take any of the following actions:
(1)
suspend an incentive payment until the provider has removed the deficiency to
the satisfaction of the department;
(2) require full repayment of all or a
portion of an incentive payment;
(3) terminate participation in the Alaska
Medicaid electronic health record incentive program;
(4) terminate or suspend participation in the
Medicaid program in this state.
(e) Any action taken by the department under
(d) of this section may be appealed by the provider under
7
AAC 165.080.
Notes
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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