D.C. Mun. Regs. tit. 29, r. 29-978
A provider who disagrees with the Notice of Program Reimbursement ("NPR") may request an informal review of the NPR by sending a written request for informal review to the Financial Manager, Commission on Health Care Finance, Department of Health, 2100 Martin Luther King, Jr. Avenue, SE, Fourth Floor, Washington, D.C. 20020, or may request a hearing by filing a notice of appeal with the Board of Appeals and Review. The request for a hearing shall be in writing and filed with the Board of Appeals and Review, 441 4th Street, N.W., 5th Floor South-Suite 540, Washington, D.C. 20001, within thirty (30) days after the date of the NPR.
The written request for an informal review shall include an identification of the specific audit adjustment or estimated budget item(s) to be reviewed, the reason for the request for review of that item and supporting documentation.
A request for an informal review shall be received within thirty (30) days of the date of the Notice of Program Reimbursement.
The Medicaid program shall mail a formal response to the provider no later than forty-five (45) days from the date of receipt of the provider's written request for a review as set forth in § 978.2.
Decisions made by the Medicaid Program and communicated in the formal response described in § 978.4 may be appealed, within forty-five (45) days of the date of the Department's letter notifying the provider of the decision, to the Board of Appeals and Review.
Filing an appeal with the Board of Appeals and Review shall not stay any action to recover any overpayment to the provider and the provider shall be immediately liable to the Medicaid Program for overpayment set forth in the Medicaid Program's formal response.
D.C. Mun. Regs. tit. 29, r. 29-978