<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.89.07" title_num="10" subtitle_num="09" chapter_num="89" heading="Denial, Emergency Suspension of Approval, and Disciplinary Action.">
  <paragraph num="A.">
    <text>Denial of Approval.</text>
    <paragraph num="(1)">
      <text>If the Department proposes to deny approval to an applicant under the provisions of this chapter, the Department shall give written notice of the proposed denial to the:</text>
      <paragraph num="(a)">
        <text>Provider applicant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Care coordination organization (CCO); and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Administrative service organization (ASO).</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>In the notice under §A(1) of this regulation, the Department shall include:</text>
      <paragraph num="(a)">
        <text>The date on which the Department proposes to deny approval;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The facts that warrant the proposed denial of approval;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Citation of the regulation or regulations upon which the proposed denial is based;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Notification that before the denial of approval, the provider may request a hearing under the provisions of COMAR 10.21.16; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>When feasible, notification of a case resolution conference.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Disciplinary Action.</text>
    <paragraph num="(1)">
      <text>The Department may propose to take any of the following disciplinary actions against a provider:</text>
      <paragraph num="(a)">
        <text>Revocation of approval;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Suspension of approval;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Probation with conditions; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Banning new admissions.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The Department may propose to take one of the actions outlined in §B(1) of this regulation if the provider:</text>
      <paragraph num="(a)">
        <text>Is out of compliance with the requirements of this chapter;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Fails to maintain financial viability; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Obtains or attempts to obtain approval or payment by fraud, misrepresentation, or the submission of false information to the Department.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Except under §C of this regulation, the Department shall send written notice of the proposed action not less than 45 calendar days in advance of the proposed action taken under this regulation to the:</text>
      <paragraph num="(a)">
        <text>Provider;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>CCO;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>ASO; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Applicable CSA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>In the notice under §B(3) of this regulation, the Department shall include:</text>
      <paragraph num="(a)">
        <text>The date on which the Department proposes to take action and, when feasible, the date of a case resolution conference;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The facts that warrant the proposed action;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Citation of the regulation or regulations upon which the proposed action is based; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Notification that, before the action, the provider has the right to request a hearing under the provisions of COMAR 10.21.16.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>If, after notice and opportunity to be heard, the Department takes disciplinary action, the provider shall, within 10 working days:</text>
      <paragraph num="(a)">
        <text>Notify individuals or the guardians of individuals receiving services of the action; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If the program ceases operations:</text>
        <paragraph num="(i)">
          <text>Notify individuals or the guardians of individuals receiving services of the suspension; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Cooperate with the CCO, child and family team, and the Department in accessing appropriate alternate services for individuals served by the provider.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Emergency Suspension of Approval.</text>
    <paragraph num="(1)">
      <text>Under State Government Article, §10-226, Annotated Code of Maryland, upon findings of conditions that pose an imminent risk to the health, safety, or welfare of an individual served by a provider, the Department may order the immediate suspension of the approval of the provider and the cessation of operation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the Department takes the action under §C(1) of this regulation, the Department shall promptly give written notice of the proposed emergency suspension to the:</text>
      <paragraph num="(a)">
        <text>Provider;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>CCO;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>ASO; and,</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Applicable CSA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>In the notice under §C(2) of this regulation, the Department shall include:</text>
      <paragraph num="(a)">
        <text>The proposed effective date of the emergency suspension;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>When feasible, the date of a pre-deprivation hearing and a case resolution conference before the Department’s final action;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The findings under §C(1) of this regulation and the reasons that support the findings; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Notification that:</text>
        <paragraph num="(i)">
          <text>Following the emergency suspension, the provider may request a hearing under the provisions of COMAR 10.21.16; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The emergency suspension may lead to revocation of the approval if the violation or violations are not corrected within the time period specified by the Department.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>If the Department suspends approval, the provider shall immediately:</text>
      <paragraph num="(a)">
        <text>Notify individuals or the guardians of individuals receiving services of the suspension;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Cooperate with the CCO, child and family team, and the Department in accessing appropriate alternate services for individuals in the program; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Cease operations of the program.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>