Conn. Agencies Regs. § 17-83k-1 - General statement

(a) General statement. Section 17-83k of the General Statutes provides for administrative sanctions against vendors of goods or services performed for or sold to beneficiaries under the medicare program, medicaid program, aid to families with dependent children program, state supplement to the federal supplemental security income program, or any federal or state energy assistance program or general assistance program, including suspension or termination from said programs. This act also provides for department notification of the proper professional society and licensing agency of any violation thereof.

The following are policies and procedures for Administrative Sanctions to be imposed against vendors or providers of goods or services performed for or sold to beneficiaries under said programs for violations including, but not limited to, those hereinafter set forth.

(b) Definitions

(1) 'Vendor' and 'provider' mean any person acting on his own behalf or on behalf of an entity and any entity furnishing goods or services.

(2) 'The commissioner' means the commissioner or his duly authorized representative.

(3) 'Suspension' means limiting program participation of vendors who, although not convicted of program-related crimes, are found by the department to have violated rules, regulations, standards, and/or laws governing said program.

(4) 'Termination' means foreclosing program participation by vendors who have been convicted of a crime involving program participation.

(5) 'Convicted' means that a judgment of conviction has been entered by a federal, state, or local court, regardless of the plea upon which it was based or whether an appeal from that judgment is pending.

(6) 'Violations' are (1) false statements of representations knowingly and willfully made or caused to be made for the purpose of claiming or determining payment, or (2) services furnished or ordered in excess of the recipient's need, or (3) failure to adhere to conditions of vendor participation in the program.

(7) 'Ownership or control interest' means a person or corporation that:

(A) Has an ownership interest totalling 5 percent or more in a disclosing entity;

(B) Has an indirect ownership interest equal to 5 percent or more in a disclosing entity;

(C) Has a combination of direct and indirect ownership interests equal to 5 percent or more in a disclosing entity;

(D) Owns an interest of 5 percent or more in any mortgage, deed of trust, note, or other obligation secured by the disclosing entity if that interest equals at least 5 percent of the value of the property or assets of the disclosing entity;

(E) Is an officer or director of a disclosing entity that is organized as a corporation; or

(F) Is a partner in a disclosing entity that is organized as a partnership.

Notes

Conn. Agencies Regs. § 17-83k-1

Effective October 29, 1985