Md. Code Regs. 10.09.89.07

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.89.07 - Denial, Emergency Suspension of Approval, and Disciplinary Action

A. Denial of Approval.

(1) If the Department proposes to deny approval to an applicant under the provisions of this chapter, the Department shall give written notice of the proposed denial to the:

(a) Provider applicant;

(b) Care coordination organization (CCO); and

(c) Administrative service organization (ASO).

(2) In the notice under §A(1) of this regulation, the Department shall include:

(a) The date on which the Department proposes to deny approval;

(b) The facts that warrant the proposed denial of approval;

(c) Citation of the regulation or regulations upon which the proposed denial is based;

(d) Notification that before the denial of approval, the provider may request a hearing under the provisions of COMAR 10.21.16; and

(e) When feasible, notification of a case resolution conference.

B. Disciplinary Action.

(1) The Department may propose to take any of the following disciplinary actions against a provider:

(a) Revocation of approval;

(b) Suspension of approval;

(c) Probation with conditions; or

(d) Banning new admissions.

(2) The Department may propose to take one of the actions outlined in §B(1) of this regulation if the provider:

(a) Is out of compliance with the requirements of this chapter;

(b) Fails to maintain financial viability; or

(c) Obtains or attempts to obtain approval or payment by fraud, misrepresentation, or the submission of false information to the Department.

(3) Except under §C of this regulation, the Department shall send written notice of the proposed action not less than 45 calendar days in advance of the proposed action taken under this regulation to the:

(a) Provider;

(b) CCO;

(c) ASO; and

(d) Applicable CSA.

(4) In the notice under §B(3) of this regulation, the Department shall include:

(a) The date on which the Department proposes to take action and, when feasible, the date of a case resolution conference;

(b) The facts that warrant the proposed action;

(c) Citation of the regulation or regulations upon which the proposed action is based; and

(d) Notification that, before the action, the provider has the right to request a hearing under the provisions of COMAR 10.21.16.

(5) If, after notice and opportunity to be heard, the Department takes disciplinary action, the provider shall, within 10 working days:

(a) Notify individuals or the guardians of individuals receiving services of the action; and

(b) If the program ceases operations:

(i) Notify individuals or the guardians of individuals receiving services of the suspension; and

(ii) Cooperate with the CCO, child and family team, and the Department in accessing appropriate alternate services for individuals served by the provider.

C. Emergency Suspension of Approval.

(1) Under State Government Article, § 10-226, Annotated Code of Maryland, upon findings of conditions that pose an imminent risk to the health, safety, or welfare of an individual served by a provider, the Department may order the immediate suspension of the approval of the provider and the cessation of operation.

(2) If the Department takes the action under §C(1) of this regulation, the Department shall promptly give written notice of the proposed emergency suspension to the:

(a) Provider;

(b) CCO;

(c) ASO; and,

(d) Applicable CSA.

(3) In the notice under §C(2) of this regulation, the Department shall include:

(a) The proposed effective date of the emergency suspension;

(b) When feasible, the date of a pre-deprivation hearing and a case resolution conference before the Department's final action;

(c) The findings under §C(1) of this regulation and the reasons that support the findings; and

(d) Notification that:

(i) Following the emergency suspension, the provider may request a hearing under the provisions of COMAR 10.21.16; and

(ii) The emergency suspension may lead to revocation of the approval if the violation or violations are not corrected within the time period specified by the Department.

(4) If the Department suspends approval, the provider shall immediately:

(a) Notify individuals or the guardians of individuals receiving services of the suspension;

(b) Cooperate with the CCO, child and family team, and the Department in accessing appropriate alternate services for individuals in the program; and

(c) Cease operations of the program.

Md. Code Regs. 10.09.89.07

Regulations .07 adopted effective 41:19 Md. R. 1077, eff.10/1/2014