Section 7 AAC 105.220 - Provider responsibilities(a) Providing medical or medically related services to recipients or billing the department for those services constitutes agreement by the provider to (1) comply with all applicable federal and state laws related to providing medical or medically related services to Medicaid recipients in this state, including laws related to recipient confidentiality, electronic transactions, scope of practice, and civil rights;(2) submit claims in the form or format required by the department for claim submission; and(3) cooperate in reports, surveys, reviews, or audits conducted by the department.(b) A provider shall retain records necessary to disclose fully to the department the extent of services provided to recipients. Information regarding a payment must be made available, upon request, to state and federal personnel of agencies associated with the Medicaid program.(c) A provider shall allow on-site inspection by authorized representatives of both state and federal agencies associated with the Medicaid program.(d) A provider is responsible for claims submitted or certified by an authorized representative.(e) A provider's or agent's endorsement of a check received from the department certifies that the claim for which the check is payment is true and accurate unless written notice of an error is sent by the provider to the department no more than 30 days after the date that the check is negotiated.(f) In accordance with 7 AAC 105.400, a provider must refund to the department any paid claim that the department finds, after post-payment review under 7 AAC 160.100 - 7 AAC 160.140, does not meet the requirements of 7 AAC 105 - 7 AAC 160.Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199; am 3/1/2024, Register 249, April 2024Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040