Section 7 AAC 165.080 - Appeals(a) A provider may appeal the department's decision to do any of the following: (1) deny participation in the Alaska Medicaid electronic health records incentive program under 7 AAC 165.030;(2) suspend an incentive payment under 7 AAC 165.050;(3) require repayment of all or a portion of an incentive payment under 7 AAC 165.050;(4) terminate participation in the Alaska Medicaid electronic health record incentive program under 7 AAC 165.050;(5) terminate or suspend participation in the Medicaid program in this state under 7 AAC 105.400 - 7 AAC 105.490.(b) To appeal a decision by the department a provider must submit a written request for a first-level appeal to the department no later than 30 days after the date of the department's letter denying participation. The request for a first-level appeal must specify the basis upon which the department's decision is challenged and include any supporting documentation. A first-level appeal will be conducted by the supervisor who oversees the health information technology program in the department.(c) Upon receipt of a request for a first-level appeal, if the department has suspended an incentive payment, the department may continue suspending the payment until a final determination is made regarding the appropriateness of the suspension.(d) The department will notify the provider in writing of the department's first-level appeal decision.(e) A provider who is not satisfied with the first-level appeal decision under (d) of this section may request a second-level appeal by submitting a written request to the commissioner no later than 30 days after the date of the first-level appeal decision. The request for second-level appeal must include (1) a copy of the department's first-level appeal decision;(2) a description of the basis upon which the decision is being appealed;(3) a copy of the first-level appeal submitted by the provider; and(4) any additional supporting documentation that supports the basis upon which the provider is making the appeal.(f) The commissioner's review of the original appeal record, decision, and any additional material submitted by the provider and the department constitutes the second-level appeal. A decision by the commissioner under this subsection is the final administrative decision of the department. The department will notify the provider of the provider's right to appeal to the superior court under the Alaska Rules of Appellate Procedure.Eff. 6/1/2011, Register 198; am 1/20/2013, Register 205; am 4/1/2017, Register 221, April 2017The address for sending an appeal under 7 AAC 165.080 is State of Alaska, Department of Health and Social Services, Commissioners Office, Attention: EHR Appeals, P.O Box 110601 Juneau, AK 99811-0601.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040