D.C. Mun. Regs. tit. 29, r. 29-5017

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

Rule 29-5017 - APPEALS FOR PROVIDERS AGAINST WHOM A RECOUPMENT IS MADE

5017.1

The Provider shall have sixty (60) 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 "Manager, Division of Program Integrity, DHCF".

5017.2

The 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.

5017.3

DHCF shall mail a written determination relative to the administrative review to the provider no later than one hundred twenty (120) days from the date of the written request for administrative review pursuant to § 5017.1.

5017.4

Within fifteen (15) 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 Office of Administrative Hearings (OAH), 441 4th Street, NW, Suite 450 North, Washington, D.C. 20001.

5017.5

Filing an appeal with the OAH shall not stay any action to recover any overpayment.

D.C. Mun. Regs. tit. 29, r. 29-5017

Final Rulemaking published at 60 DCR 15537 (November 8, 2013); amended by Final published at 63 DCR 014134 (11/18/2016)

Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes approved December 27, 1967 (81 Stat.774; D.C. Official Code § 1-307.02 (2012 Repl.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).