12 Va. Admin. Code § 30-122-130 - Provider termination
A. Except
as otherwise provided by applicable federal or state law, the Medicaid provider
agreement may be terminated by DMAS (i) pursuant to §
32.1-325
of the Code of Virginia, (ii) as may be required by federal law for federal
financial participation, and (iii) in accordance with the provider
participation agreement, including termination at will on 30 days written
notice. The agreement may be terminated if DMAS determines that the provider
poses a threat to the health, safety, or welfare of any individual enrolled in
a DMAS administered program. DMAS may also terminate a provider's participation
agreement if the provider does not fulfill its obligations as described in the
provider participation agreement. Such provider agreement terminations shall be
in accordance with §
32.1-325
of the Code of Virginia,
12VAC30-10-690,
and Part XII (12VAC30-20-500 et
seq.) of 12VAC30-20. Termination precludes further payment by DMAS for services
provided for individuals subsequent to the date specified in the termination
notice.
B. A provider who has been
convicted of a felony, or who has otherwise pled guilty to a felony, in
Virginia or in any other state, the District of Columbia, or the United States
territories shall, within 30 days of such conviction, notify DMAS of this
conviction and relinquish his provider agreement. Such provider agreement
terminations shall be effective immediately and conform to §
32.1-325
of the Code of Virginia and
12VAC30-10-690.
Providers shall not be reimbursed for services that may be rendered between the
conviction of a felony and the provider's notification to DMAS of the
conviction.
C. A participating
provider may voluntarily terminate his participation with DMAS by providing 30
days written notification.
Notes
Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.
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