CA Welf & Inst Code Section 11466.36


The department may terminate a program rate if any of the following conditions are met:


The department determines that, based upon the findings of a hearing officer, a rate application or information submitted by a provider was fraudulently submitted to the department.


A provider is failing to provide services in accordance with the standards associated with its paid rate or in accordance with its program statement.


A provider with an outstanding sustained overpayment incurs a second sustained overpayment, and is unable to repay the sustained overpayments.


A provider has a sustained overpayment that represents 100 percent of a provider’s annual rate reimbursement.


A provider has a sustained overpayment and has failed to timely submit its payments on more than three occasions in a 12-month period.


This chapter shall not be construed to affect the department’s authority under other provisions of law for collection of provider sustained overpayments.
Last Updated

Aug. 19, 2023

§ 11466.36’s source at ca​.gov