PURPOSE: This rule adds violations determined by the Department of Health and Senior Services as independent grounds for provider sanctions.

Violations of 13 CSR 70-3.030(3) identified by the Department of Health and Senior Services (DHSS) or its designee during the course of an investigation shall be considered for purposes of sanctions without the need for further investigation by the Missouri Medicaid Audit and Compliance Unit (MMAC). The DHSS shall report any such violations by sworn affidavit to MMAC. Prior violations of 13 CSR 70-3.030(3) or other program violations, including, but not limited to, program violations as determined by and attested to by affidavit by the DHSS, shall be considered in their totality to determine if there is an ongoing pattern of violations. Such pattern of violations shall weigh heavily to support invoking severe sanctions.

AUTHORITY: sections 1.205, 208.153, 208.201, and 660.017, RSMo 2016.* Emergency rule filed Oct. 1, 2021, effective Oct. 18, 2021, expired April 15, 2022. Original rule filed Oct. 1, 2021, effective May 30, 2022.

*Original authority: 1.205, RSMo 1986; 208.153, RSMo 1967, amended 1967, 1973, 1989, 1990, 1991, 2007, 2012; 208.201, RSMo 1987, amended 2007; and 660.017, RSMo 1993, amended 1995.