§ 52.62. Prohibition of services.
(a) A provider may be sanctioned, prohibited or disenrolled from providing services for failure to perform any of the following:
(1) Protect the health and welfare of a participant during service delivery.
(2) Comply with applicable Federal or State laws and this chapter.
(3) Comply with a provision of the MA provider agreement, including the waiver addendum.
(4) Deliver a service in the type, scope, amount, duration and frequency required by the approved service plan when the participant is available for the delivery of the service.
(5) Develop or implement a CAP.
(6) Maintain licenses or certifications, or both, as required by Federal or State agencies.
(7) Maintain accurate records.
(b) The Department may prohibit a provider from providing new participants with services if the provider violates subsection (a).
(c) A disenrolled provider shall cooperate with the Department, new providers of services and participants with transition planning to ensure participant’s continuity of care.
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