Section 29-5111. APPEALS FOR PROVIDERS AGAINST WHOM A RECOUPMENT IS MADE

 

5111.1The Provider shall have sixty days from the date of the NR to request an administrative review of the NR. The request for administrative review of the NR shall be submitted to Chief, Office of Program Integrity, Medical Assistance Administration, Department of Health.

 

5111.2The written request for administrative review shall include a specific description of the item to be reviewed, the reason for the request for review, the relief requested, and documentation in support of the relief requested.

 

5111.3MAA 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 pursuant to subsection 5111.1.

 

5111.4Within 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, NW, Suite 540South, Washington, DC 20001.

 

5111.5Filing an appeal with the Board of Appeals and Review shall not stay any action to recover any overpayment.

 

source

Final Rulemaking published at 50 DCR 3957 (May 23, 2003).