(a)
The department may terminate a program rate if any of the following conditions are met:(1)
The department determines that, based upon the findings of a hearing officer, a rate application or information submitted by a provider was fraudulently submitted to the department.(2)
A provider is failing to provide services in accordance with the standards associated with its paid rate or in accordance with its program statement.(3)
A provider with an outstanding sustained overpayment incurs a second sustained overpayment, and is unable to repay the sustained overpayments.(4)
A provider has a sustained overpayment that represents 100 percent of a provider’s annual rate reimbursement.(5)
A provider has a sustained overpayment and has failed to timely submit its payments on more than three occasions in a 12-month period.(b)
This chapter shall not be construed to affect the department’s authority under other provisions of law for collection of provider sustained overpayments.
Source:
Section 11466.36, https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=11466.36..