37.85.505    FACTORS GOVERNING IMPOSITION OF SANCTION

(1) The decision to impose sanctions and which sanctions to impose shall be within the discretion of the department except as provided in (3).

(2) The following factors shall be considered in determining the sanction(s) to be imposed:

(a) seriousness of the offense(s);

(b) extent of violations;

(c) history of prior violations;

(d) prior imposition of sanctions;

(e) prior provision of provider education;

(f) provider willingness to comply with program rules;

(g) whether a lesser sanction will be sufficient to remedy the problem;

(h) actions taken or recommended by peer review groups or licensing boards.

(3) Where a provider has been found by a court of competent jurisdiction in either a civil or criminal proceeding to have defrauded the Montana Medical Assistance program, or has been previously suspended due to program abuse, or has been terminated from the Medicare program for fraud or abuse, the department may terminate the provider from the Medical Assistance program.

History: 53-2-201, 53-2-803, 53-4-111, 53-6-108, 53-6-111, 53-6-113, MCA; IMP, 53-2-306, 53-2-801, 53-4-112, 53-6-106, 53-6-107, 53-6-111, MCA; NEW, 1980 MAR p. 1619, Eff. 6/13/80; AMD, 1984 MAR p. 1639, Eff. 11/16/84; TRANS, from SRS, 2000 MAR p. 479.