§ 20-10-2405 — Penalties and sanctions

(a) The Department of Human Services may impose any sanction allowed under this section and may suspend or limit new admissions of Medicaid beneficiaries to the facility in the event of any of the following and continued until the facility demonstrates full compliance to the satisfaction of the department: (1) The facility fails to file a complete and timely cost report or fails to provide a complete and timely response to a request by the department or the designated contractor of the department for corrections, additional information, or supporting documentation; (2) The facility obstructs or otherwise fails to fully cooperate with any state or federal inspection and copying of facility records or data; (3) The facility obstructs or otherwise fails to fully cooperate with an independent audit ordered by the department; or (4) The department determines, directly or based on findings of a designated contractor of the department, an independent auditor, or the Office of Medicaid Inspector General that: (A) A reasonable cause to believe that the facility's cost report or responses, or any records supporting the facility's cost report or responses, are false, misleading, or otherwise erroneous exists; (B) The facility lacks the necessary financial records and other documentation to provide a complete and accurate cost report, verify the correctness of information contained in the cost report, or support an independent audit of the cost report and the facility's finances; or (C) The facility lacks the necessary accounting, financial management, recordkeeping, and reporting capabilities and practices to comply with generally accepted accounting principles and the cost-reporting instructions of the department. (b) The department may impose and collect a monetary penalty of five hundred dollars ($500) per single violation on an assisted living facility in the event of the following: (1) The facility is thirty (30) or more days overdue in filing a complete cost report or a complete response to a request by the department or the designated contractor of the department for corrections, additional information, or supporting documentation; (2) The facility obstructs or otherwise fails to fully cooperate with any state or federal inspection and copying of facility records or data; or (3) The facility obstructs or otherwise fails to cooperate with an independent audit ordered by the department fully. (c) (1) Compliance with the cost-reporting, auditing, and record inspection requirements is a condition of Medicaid certification and Medicaid payment for assisted living facilities. (2) The department shall enforce assisted living facility compliance with the requirements of this subchapter through Medicaid provider decertification and exclusion from participation in the Arkansas Medicaid Program. (d) (1) For material, substantial, or repeated noncompliance with cost-reporting, auditing, and record inspection requirements, the department may: (A) Terminate the facility's Medicaid certification; (B) Limit the number of Medicaid residents in the facility; and (C) Exclude the facility from Medicaid participation for five (5) years. (2) The department shall promptly terminate the facility's Medicaid certification and exclude the facility and the facility's certifying officer and responsible financial officers from participating in Medicaid for a minimum period of five (5) years for: (A) Filing of a false or misleading cost report or response; (B) Providing false or misleading records or other documentation to support a cost report or response; or (C) Providing false or misleading information to an independent auditor or federal or state agency inspecting facility records.

Legislative History

Added by Act 2023, No. 198,§ 1, eff. 8/1/2023.