10A NCAC 45A .0305       DISQUALIFICATION

(a)  A provider shall be disqualified from all Department payment programs upon disqualification from Medicaid, Medicare, or the Child Health Services Block Grant Program (Title V of the Social Security Act).

(b)  The period of disqualification shall be equal to the period specified by the federal government for disqualification from Medicaid, Medicare, or the Child Health Services Block Grant Program (Title V of the Social Security Act).

(c)  Written notification of disqualification from Department payment programs shall be given to the provider.  The notification shall inform the provider of the provider's right to appeal the disqualification.

(d)  Authorizations for services provided prior to the date of disqualification from Department programs shall be honored by the Department.  Authorizations for services which have not been provided prior to disqualification shall be cancelled unless the provider has made a financial commitment based upon the authorization.

History Note:        Authority G.S. 130A‑5(3); 130A‑124; 130A‑127; 130A‑129; 130A‑177; 130A‑205;

Eff. March 1, 1989;

Transferred and Recodified from 10 NCAC 4C .0306 Eff. April 4, 1990;

Amended Eff. December 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 13, 2015.