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Medicaid program under 7 AAC 105.420(c), that provider may not submit a claim, either directly or through another entity, for payment for any service provided to a recipient
(1) on or after the date the provider was suspended or terminated; or
(2) before the date the provider was suspended or terminated for which the provider had not yet submitted a claim to the department for payment. (b) A Medicaid provider may not submit to the department a claim for payment for a service provided to a recipient if that service was provided by an employee or agent of the provider who has been suspended or terminated from participation in the Medicaid program, except for those services provided before the suspension or termination. Services provided before the suspension or termination are subject to any sanction that may apply to that provider under 7 AAC 105.410. (c) If a provider of services violates (b) of this section, the department may suspend or terminate the provider from participation in the Medicaid program. (Eff. 2/1/2010, Register 193) Statutory Authority: Authority: AS 47.05.010 AS 47.07.040 7 AAC 105.440. Notice of sanction. (a) When the department determines that a sanction against a provider is warranted under 7 AAC 105.400 — 7 AAC 105.420, the department will send written notice of the determination to the provider by certified mail. In the notice, the department will include
(1) the grounds for sanction under 7 AAC 105.400, including all relevant facts;
(2) the proposed sanction to be imposed by the department under 7 AAC 105.410 — 7 AAC 105.420;
(3) whether the matter has been referred for fiscal audit under 7 AAC 160.110;
(4) any action required of the provider; and
(5) the provider’s right to an appeal under 7 AAC 105.460. (b) The proposed sanction is effective 30 days after the date on the notice if the provider does not request an appeal or submit the information required under 7 AAC 105.460 30 days or less after the date on the notice or 30 days after the date of the final administrative appeal