1. (a) Except as provided under (c) of this section, if one or more grounds for sanction exist under 7 AAC 105.400, the department will determine which sanction to impose under 7 AAC 105.410.

2. (b) The department will consider the following factors in determining the sanction to be imposed:

   1. (1) seriousness of the offense;
   2. (2) extent of violations;
   3. (3) history of prior violations;
   4. (4) prior imposition of sanctions;
   5. (5) prior provision of provider education;
   6. (6) provider willingness to obey program rules;
   7. (7) whether a lesser sanction will be sufficient to remedy the problem; and
   8. (8) actions taken or recommended by peer-review groups or licensing boards.

3. (c) The department will initiate proceedings to suspend or terminate a provider from the Medicaid program under 7 AAC 105.410, if a provider or an employee of the provider has

   1. (1) been convicted of medical assistance fraud under AS 47.05.210;
   2. (2) been convicted of a crime the department considers a risk to the health or safety of a recipient, including a barrier crime under 7 AAC 10.905;
   3. (3) been previously suspended under 7 AAC 105.410 due to program abuse or abuse of a recipient;
   4. (4) violated 7 AAC 105.430(c); or
   5. (5) terminated from the Medicare program for fraud or abuse of the Medicare program.

(Eff. 2/1/2010, Register 193)

Authority: AS 47.05.010, AS 47.07.040