Haw. Code R. § 17-1736-23 - Suspension or termination

(a) The decision to suspend or terminate a provider from participation in the medical assistance program and the duration of any suspension shall be made by the DHS director.

(b) The duration of the suspension imposed by the DHS director shall be conditioned upon the seriousness of the infraction but shall not exceed a period of five years.

(c) The DHS director shall suspend or terminate any provider in the medical assistance program who has been suspended or terminated from the medicare program. Suspension or termination from the medical assistance program if based upon suspension from the medicare program shall be at least under the same conditions and for the same period of time as the suspension from the medicare program. The DHS director may determine that more stringent action under the medical assistance program than was taken under the medicare program is justified. In that event, the director shall take such steps as the director deems appropriate subject to the provisions of subchapter 3.

(d) The DHS director shall suspend or terminate any provider in the medical assistance program whose license, certification, authorization or permit to practice is not current or has been suspended, revoked, or restricted by a state or federal government, court, or agency.

(e) A provider who has terminated from the medical assistance program for a violation may not petition the director for reinstatement to the program for a period of five years at which time reinstatement may be permitted by the director, if justified, provided that at the time reinstatement is requested that no medicare sanctions remain applicable.

(f) All legal actions, both civil and criminal, against providers certified under the medicaid program shall be handled by the State's medicaid fraud control unit.

(g) Actions for suspension or termination of a provider may be initiated or continued even though a provider voluntarily withdraws from the program. The procedures for determining whether suspension or termination are appropriate and the length of time shall be governed by this subchapter and subchapter 3.

Notes

Haw. Code R. § 17-1736-23

[Eff 08/01/94] (Auth: HRS § 346-14) (Imp: 42 C.F.R. §§455.16, 455.21)