Section 7 AAC 165.030 - Participation and payment determinations(a) If the department determines that a provider meets the requirements of 7 AAC 165.010 and 7 AAC 165.020, the department will (1) send to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), an electronic request for validation, through CMS's automated national level registry, that the provider is not(B) federally sanctioned; or(C) paid, in the same year, an incentive payment from Medicare or another jurisdiction, unless the provider is a hospital provider; and(2) upon receiving validation through the CMS registry, notify the provider of the approval.(b) If the department determines that a provider does not meet the requirements of 7 AAC 165.010 and 7 AAC 165.020, or if the department does not receive validation from CMS, the department will notify the provider of the (1) reason for denial; and(2) the provider's right to request an appeal under 7 AAC 165.080.(c) If a change occurs in the information that the department used to deny participation, or that previously resulted in a failure to receive CMS validation, the provider may submit a new or updated attestation at any time during that payment year.Eff. 6/1/2011, Register 198Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040