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(f) If a provider does not submit a request for appeal or provide the information required under (a) of this section 30 days or less after the date on the notice of sanction under 7 AAC 105.440, the notice of sanction is the department’s final administrative action. (Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199) Statutory Authority: Authority: AS 47.05.010 AS 47.07.040 Editor’s note: Effective July 1, 2022, Executive Order 121 split the former Department of Health and Social Services into the Department of Health and the Department of Family and Community Services. As of Register 242 (July 2022), the regulations attorney made a conforming technical revision under sec. 138, E.O. 121 and AS 44.62.125(b)(6), to 7 AAC 105.460. 7 AAC 105.470. Restrictions on payments. (a) The department may place restrictions on the payment of claims submitted by the provider, including the necessity of the provider to obtain prior authorization of services or to submit to prepayment review of claims, if

(1) the department has reason to believe, based on reliable information, that the provider has violated its provider agreement or an applicable statute or regulation, and the department is reviewing, auditing, or investigating the provider’s compliance with the requirements of 7 AAC 105 — 7 AAC 160; or

(2) a state professional licensing or certifying agency is investigating the provider for having committed fraud, abuse, professional misconduct, unprofessional conduct, or a violation of a statute or regulation. (b) The department may continue a restriction imposed under this section until the department issues a notice of informal resolution under (d) of this section or until any related proceedings to impose sanctions against the provider under 7 AAC 105.400 — 7 AAC 105.490 are resolved. (c) Separate from any notice that the department issues under 7 AAC 105.440, the department will send written notice to a provider before it restricts payment under this section. In the notice, the department will

(1) identify the restriction and state that it has been imposed on the payment of claims