D.C. Mun. Regs. tit. 29, r. 29-1303
If the Director proposes to deny reimbursement to a provider under § 1301 or to terminate a provider agreement pursuant to § 1302, he or she shall send written notice of intent and the reasons for the proposed exclusion or termination to the provider. The notice shall include the following:
Within thirty (30) days of the date on the notice, the provider may submit documentary evidence and written argument against the proposed action.
For good cause shown, the Director may extend the thirty (30) day period prescribed in § 1303.2.
If the Director decides to exclude the provider under § 1301 or terminate the provider agreement under § 1302 after the provider has filed a response under § 1303.2, then the Director shall send written notice of his or her decision to the affected party at least fifteen (15) days before the decision becomes effective. The notice shall include the following:
If the provider files a notice of appeal within fifteen (15) days of the date of the notice of termination or exclusion, then the effective date of the proposed action shall be stayed pending a decision following final action by the D.C. Board of Appeals and Review.
Except as provided in § 1303.8 and § 1303.9, a provider who has been excluded or terminated from the District's Medicaid Program shall be precluded from submitting any claims for payment, either personally or through claims submitted by any clinic, group, corporation or other association, for any health care provided under the Medicaid Program after the effective date of the exclusion or termination.
If the provider has been excluded or terminated from participation in the Medicare Program or otherwise sanctioned because of fraud or abuse under that program, the effective date of denial of payment for services or termination from the District's Medicaid Program shall be the effective date of exclusion from the Medicare Program as established by HCFA.
Medicaid payments shall be made for inpatient services furnished in a hospital, skilled nursing facility or intermediate care facility to a recipient who was admitted before the effective date of the Medicare exclusion for up to thirty (30) days after the date of the Medicare exclusion.
Payment for home health services furnished under a plan established before the effective date of the exclusion shall be available to the extent federal financial participation is available under the federal regulation.
D.C. Mun. Regs. tit. 29, r. 29-1303