Section 29-4614. APPEALS FOR PROVIDERS AGAINST WHOM A RECOUPMENT IS MADE

 

4614.1Any provider that disagrees with the reason for a recoupment or the amount of the recoupment shall have sixty (60) days from the date of the Notice of Recoupment ("NR") to submit a written request for administrative review of the NR to the Financial Manager, Audit and Finance Office, Medical Assistance Administration, Department of Health.

 

4614.2The written request for administrative review shall include a specific description of the audit adjustment item to be reviewed, the reason for the request for review of the adjustment or item, the relief requested, and documentation in support of the relief requested.

 

4614.3The Medicaid Program shall mail a written determination relative to the administrative review to the provider no later than one hundred and twenty (120) days from the date of the written request for administrative review under 4614.1.

 

4614.4Within forty-five (45) days of receipt of the Medicaid Program's written determination, the provider may appeal the written determination by filing a written notice of appeal with the Board of Appeals and Review, 441 4th Street, N.W., Suite 540, Washington, D.C. 20001.

 

4614.5Filing an appeal with the Board of Appeals and Review shall not stay any action to recover any overpayment to the provider. The provider shall be liable immediately to the Medicaid Program for any overpayment set forth in the Medicaid Program's determination.

 

source

Final Rulemaking published at 46 DCR 6122(July 23, 1999).