Section 29-1308. SUBSEQUENT ACTION BY THE DIRECTOR

 

1308.1When a suspension is put into effect by reason of §1306.2, the suspension shall remain in effect until one (1) of the following occurs:

 

(a)The overpayment is liquidated;

 

(b)The Director enters into an agreement with the provider for liquidation of the overpayment, subject to approval by the Office of the Corporation Counsel; or

 

(c)The Director or the D.C. Board of Appeals and Review determines that there is no overpayment.

 

1308.2When the suspension is put into effect in accordance with §1306.3, the Director shall take timely action after the suspension to obtain the additional evidence as may be needed to make a determination regarding whether an overpayment exists or that payments were correct. All reasonable efforts shall be made by the Director to expedite the determinations.

 

1308.3The provider shall be immediately informed of the determination by the Director under §1308.2 and, where appropriate, suspension shall be rescinded or adjusted to take into account the determination.

 

1308.4If the suspension is not rescinded, it shall remain in effect as specified in §1308.1.

 

1308.5Nothing in this chapter shall prohibit the Director from recovering overpayments through referral of the case to the Office of the Corporation Counsel for appropriate legal action.

 

1308.6Nothing in this chapter authorizes any DHS official to compromise any claim with respect to a provider under the Medicaid Program.

 

source

Final Rulemaking published at 31 DCR 3870 (August 3, 1984).