Grounds for Denial, Revocation, or Non-renewal of Approval

Each of the following, in and of itself, shall constitute full and adequate ground on which the Department may deny an application for a Certificate of Approval, provide the applicant with the option to resubmit, revoke or refuse to renew a Certificate of Approval to operate an MIH or Community EMS Program: (A) Failure to meet applicable requirements for approval as specified in 105 CMR 173.000; (B) Failure to meet the requirements of applicable federal or state law or regulations; (C) Failure to provide information as required within 105 CMR 173.000; (D) Any action or condition that endangers public health and safety, as determined by the Department; (E) Obtaining or attempting to obtain a Certificate of Approval or renewal thereof by fraud, misrepresentation, or knowing omission(s) of material information, or by submission of incorrect, false or misleading information; (F) Fraud, deceit or knowing omission(s) of material information or providing false or misleading statements, orally or in writing, to the Department; (G) Conviction of an applicant, approved entity or person with significant financial or management interest in the MIH or Community EMS Program, whether proposed or in operation, of Medicare or Medicaid fraud, or other criminal offense related to the operation of the program or indicating that operation of the program may endanger public health or safety; (H) Reasonable basis for the Department to conclude that a discrepancy exists between the representations by the applicant as to the MIH or Community EMS Program services to be afforded patients and the services actually rendered or to be rendered; (I) Failure to meet the duties and responsibilities for MIH or Community EMS Programs as required by 105 CMR 173.000; (J) Failure to comply with any term or condition prescribed by the Department within a Certificate of Approval; (K) Failure to submit an acceptable plan of correction as required under 105 CMR 173.120; (L) Failure to comply with a Department-approved plan of correction or correction order in accordance with 105 CMR 173.120; (M) Denial of entry to Department agents to conduct site visits or inspections, or an attempt to impede the work of Department agents; or (N) Any other violation of M.G.L. c. 111O, 105 CMR 173.000, or related Department guidelines. Nothing in 105 CMR 173.080 shall limit the Department from adopting additional grounds through adjudication.