10A NCAC 26C .0504. REVOCATION

(a)  The DMH/DD/SAS shall revoke authorization to receive funding to provide services utilizing state or federal mental health, developmental disabilities and substance abuse services funds and make a recommendation to DMA to revoke enrollment for Medicaid, when it finds that there has been substantial failure to comply with statutes or pursuant to Rule .0502(5) of this Section.  Where funding is authorized by other public sources, the DMH/DD/SAS shall refer its findings to the funding authority.  Regardless of funding authority, the DMH/DD/SAS shall refer findings concerning licensed providers for investigation by the licensing agency when it determines there has been substantial failure to comply with statutes or rules.  The DMH/DD/SAS shall include its findings in the revocation order, recommendation or referral.

(b)  Before revoking authorization, making a recommendation to the Division of Medical Assistance (DMA) or making a referral to another funding authority or licensing agency, the DMH/DD/SAS shall provide written notice to the provider stating that continued failure to comply with statutes or rules will result in the revocation, recommendation and referral.

(c)  The DMH/DD/SAS shall give the provider written notice of the revocation order, the recommendation to DMA or referral of findings to the funding authority or licensing agency, as applicable. The written notice shall include the reasons for the action, and the grievance/appeal process or contested case procedures pursuant to G.S. 150B.

(d)  The revocation notice shall be effective on the date specified in the notice or on the date of the first attempt to deliver notification at the last known address of the provider, whichever is later.

(e)  The DMH/DD/SAS shall provide to DMA or other funding authority a written notice of the revocation order and a recommendation to revoke Medicaid enrollment.  The DMH/DD/SAS shall also provide a copy of the notice and recommendation to the licensing agency, as applicable.

(f)  The provider may contest the order by requesting a contested case hearing pursuant to G.S. 150B.  Requesting a contested case hearing does not stay the revocation order. 

 

History Note:        Authority G. S. 122C-112.1; 143B-139.1; 150B-21.1;

Temporary Adoption Eff. July 1, 2003;

Eff. July 1, 2004.