9411.1 If the Director proposes to deny enrollment to a provider pursuant to this chapter, then the Director shall send written notice to the affected party. The notice shall include the following:

1. (a) The basis and reasons for the proposed denial of enrollment;
2. (b) Information regarding the affected party's right to dispute the allegations and to submit evidence to support his or her position; and
3. (c) Specific reference to the particular sections of relevant statutes, rules, provider agreement, guidance, and provider manuals for any unmet screening requirement and any deficiencies cited.

9411.2 Within thirty (30) calendar days of the date on the notice, the affected party may submit to DHCF documentary evidence and accompanying written argument against the proposed denial of enrollment.

9411.3 If the Director decides to deny enrollment after the provider files a response, then the Director shall send written notice of the denial of enrollment to the provider. The notice shall include the following:

1. (a) The reason for the decision;
2. (b) The effective date of the decision;
3. (c) The earliest date on which the Director shall accept an application for enrollment;
4. (d) The requirements and procedures for enrollment in the District's Medicaid program; and
5. (e) Information regarding the provider's right to request a hearing by filing a notice of appeal with the Office of Administrative Hearings.

9411.4 If the provider files a notice of appeal within fifteen (15) calendar days of the date of the denial of enrollment, then the effective date of the proposed action shall be stayed pending a decision following final action by the Office of Administrative Hearings.

SOURCE: Final Rulemaking published at 60 DCR 10041 (July 12, 2013); as amended by Final Rulemaking published at 68 DCR 4255 (April 23, 2021).