Refusal To Enter Into An Agreement

The Department may refuse to enter into a provider agreement for the reasons described in this rule. (3-17-22) 01. Convicted of a Felony. The provider has been convicted of a felony under federal or state law. (3-17-22) 02. Committed an Offense or Act Not in Best Interest of Medicaid Participants. The provider has IDAHO ADMINISTRATIVE CODE IDAPA 16.05.07 – Investigation & Department of Health & Welfare Enforcement of Fraud, Abuse, & Misconduct Section 270 Page 14 committed an offense or act which the Department determines is inconsistent with the best interests of Medicaid participants. (3-17-22) 03. Failed to Repay. The provider has failed to repay the Department monies which had been previously determined to have been owed to the Department. (3-17-22) 04. Investigation Pending. The provider has a pending investigation for program fraud or abuse. (3-17-22) 05. Terminated Provider Agreement. The provider was the managing employee, officer, or owner of an entity whose provider agreement was terminated under Section 230 of these rules. (3-17-22) 266. -- 269. (RESERVED)