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(1) monitor the recipient’s use of Medicaid services for 90 days; or
(2) notify the recipient, in writing,
(A) that the department will restrict the recipient’s choice of provider as provided in (d) of this section; and
(B) of the recipient’s fair hearing rights under 7 AAC 49. (d) The department will assign a restricted recipient one primary care provider and one pharmacy within reasonable proximity to the recipient’s home, and may assign one dental provider and one behavioral health provider, also within reasonable proximity. The department will include the word “RESTRICTED” and will identify the designated providers on the recipient’s Medicaid identification card. (e) A restricted recipient may obtain services and items from only the designated providers identified under (d) of this section, except that
(1) the recipient may receive medical services from a non-designated enrolled provider if the designated provider refers the recipient to the non-designated enrolled provider;
(2) the recipient may receive emergency services from any enrolled provider. (f) The department may restrict provider choice for a reasonable period of time, not to exceed 24 months of eligibility upon initial placement, and 36 months for each subsequent placement. The department will review the restriction before the end of each placement. The department will notify the recipient, in writing before each subsequent placement,
(1) of the department’s decision to continue to restrict the recipient’s choice of provider under (d) of this section; and
(2) of the recipient’s fair hearing rights under 7 AAC 49. (g) The designation of a provider under (d) of this section may be changed only if the
(1) provider requests the change;
(2) provider disenrolls from the Medicaid program;
(3) recipient moves to a new geographic area; or
(4) department finds that the recipient does not have reasonable access to Medicaid services of adequate quality. (h) Except as provided in (e) of this section, the department will pay for a service covered under 7 AAC 105 — 7 AAC 160 that is provided to a recipient who is restricted under this section only if the service is performed by a provider designated on the recipient’s Medicaid identification card. (i) In this section,