D.C. Mun. Regs. tit. 22, r. 22-B4413

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-B4413 - UNCOMPENSATED CARE ENFORCEMENT

4413.1

If the Director finds, based on an investigation, review, or audit under § 4412, that a CON holder has not complied with the requirements of this chapter, the Director may take any action authorized by law to secure compliance, including:

(a) Voluntary agreement;

(b) Judicial enforcement of the obligations under this chapter; and

(c) Denial or withdrawal of a CON.

4413.2

Each CON holder that has denied uncompensated care to any person because it failed to comply with its uncompensated care obligation shall be out of compliance until it takes the actions necessary to remedy fully the noncompliance, including;

(a) Providing uncompensated care to applicants improperly denied;

(b) Repaying amounts improperly collected from persons eligible to receive uncompensated care; and

(c) Other corrective action the Director may prescribe.

4413.3

The Director may disallow all of the uncompensated care claimed in a fiscal year if the Director finds that a CON holder was in substantial noncompliance with its uncompensated care obligation because it failed to do any of the following:

(a) Have a system for providing notices to eligible persons as required by § 4405;

(b) Comply with the applicable reporting requirements of § 4410;

(c) Have a system for maintaining records of uncompensated care provided;

(d) Take corrective action pursuant to § 4413.2;

(e) Comply with the applicable eligibility standards in § 4406; or

(f) Comply with the written determination procedures in § 4408.

4413.4

If the Director determines, based on investigation, audit, or review under § 4412, that a CON holder has limited its services in violation of its uncompensated care obligation, the Director may require the CON holder to establish a compliance plan to ensure that the CON holder's services are available according to the requirements of this chapter.

4413.5

In the absence of a finding of noncompliance in any fiscal year, the Director may disallow uncompensated care claimed by a CON holder in the fiscal year to the extent that the services are not documented as uncompensated care according to this chapter.

D.C. Mun. Regs. tit. 22, r. 22-B4413

Final Rulemaking published at 36 DCR 5819 (August 11, 1989); as amended by Final Rulemaking published at 52 DCR 8258 (September 2, 2005); as amended by Final Rulemaking published at 53 DCR 4808 (June 16, 2006)

Authority: This chapter was originally enacted under the authority of the District of Columbia Certificate of Need Act of 1980, effective September 16, 1980 (D.C. Law 3-99; D.C. Official Code, §§ 44-1801 to 44-1817 (2001 ed.)), and amended by the District of Columbia Certificate of Need Act of 1980 Amendment Act of 1987, effective March 16, 1988 (D.C. Law 7-90; 35 DCR 710 (February 5, 1988)). Subsequent to the enactment of this chapter, the District of Columbia Certificate of Need Act of 1980 was repealed by § 22 of the Health Services Planning Program Act of 1992, effective March 16, 1993 (D.C. Law 9-197; 39 DCR 9195 (December 11, 1992)). Later authority for the regulation of Certificates of Need was found at D.C. Official Code §§ 44-401 to 44-421 (2001 ed.); Mayor's Reorganization Plan No. 3 of 1986; and Mayor's Order 95-162, dated December 4, 1995.