6 Pa. Code § 22.85 - Re-enrollment of providers whose agreements have been terminated
(a)
Request
for re-enrollment. To request re-enrollment the provider shall send a
written request to the Department. For the request to be considered, it should
include statements from peer review bodies, probation officers where
appropriate or professional associates, giving factual evidence to support
their belief that the violation leading to the termination will not be
repeated. A statement from the provider setting forth the reasons why he should
be re-enrolled should also be included.
(b)
Criteria for provider
re-enrollment. In considering the provider's request for
re-enrollment, the Department will take into account such factors as the
severity of the offense, whether there has been licensure action against the
provider, whether the provider has been convicted in a State, Federal or local
court of Medicaid offenses or similar offenses and whether there are claims or
penalties outstanding against the provider. If the Department's notice of
termination or exclusion specifies a date after which the Department will
consider re-enrolling the provider, the Department will under no circumstances
consider re-enrolling the provider before the specified date. Under §
22.101(b)(3)
(relating to provider appeals), the Department rejection of a request for
re-enrollment prior to the specified date is not subject to appeal.
(c)
Notification of action on
re-enrollment request. The provider will be notified in writing of the
Department's decision on a request for re-enrollment within 60 days of the date
of receipt of the application. The Department's notification of approval of a
re-enrollment request shall contain an effective date of
re-enrollment.
Notes
This section cited in 6 Pa. Code § 22.61 (relating to conditions of provider eligibility).
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.