Revocation of Enrollment and Sanctions

(A) The MassHealth agency has the right to review a PACT provider’s continued compliance with the conditions for enrollment referred to in 130 CMR 464.405 and the reporting requirements in 130 CMR 464.416 upon reasonable notice and at any reasonable time during the provider’s hours of operation. The MassHealth agency has the right to revoke the enrollment, subject to any applicable provisions of 130 CMR 450.000: Administrative and Billing Regulations, if the review reveals that the provider has failed or ceased to meet such conditions. (B) If the MassHealth agency determines that good cause exists for the imposition of a lesser sanction than revocation of enrollment, it may withhold payment, temporarily suspend the provider from participation in MassHealth, or impose some other lesser sanction as the MassHealth agency sees fit, pursuant to the processes set forth in 130 CMR 450.000: Administrative and Billing Regulations, as applicable.