California
Denial of Application.
22 CCR 74832
Source text
26 segments
22 CCR 74832
22 CCR 74832
§ 74832. Denial of Application.
(a)
An application for licensure or renewal of a license may be denied when an applicant or licensee:
(1)
Fails to comply with provisions in Health and Safety Code Division 2, Chapter 8.5, and Title 22 of the California Code of Regulations, Division 5, Chapter 6.5.
(2)
Fails to comply with provisions in Title 42 of the Code of Federal Regulations, Chapter 4, Subchapter B, Part 418, if applicable.
(3)
Fails to implement all plans of correction to deficiencies cited by the Department pursuant to section 74904.
(4)
Has had a hospice license involuntary suspended or revoked within the prior 24 months.
(5)
Fails to submit a complete application, or remediate all discrepancies in the application, as required by section 74812 after notification by the Department to provide additional information.
(6)
Does not demonstrate or provide evidence of an unmet need for hospice services requirement in accordance with section 74820(e) and (f).
(7)
Is liable for unpaid licensing fees required in section 74816.
(8)
Fails to hold an active status with either the California Secretary of State, the Franchise Tax Board, or both, if the applicant or the licensee is a business entity.
(9)
Provides inaccurate information on the application or any documents required to be submitted to the Department or required to be maintained by the hospice pursuant to the provisions of Title 22 of the California Code of Regulations, Division 5, Chapter 6.5.
(b)
An application for licensure or renewal of a license will be denied when an applicant or licensee has hospice management personnel whose professional license records indicate the imposition of disciplinary actions within the seven years prior to the date of the application, and the applicant or licensee fails to replace the personnel even after the Department has made the applicant or licensee aware of the need to replace the affected personnel. Examples of actions and behaviors that may lead to disciplinary actions include, but are not limited to:
(1)
Participation in fraudulent billing activities including, but not limited to:
(A)
Billing for services not performed.
(B)
Incorrect billing code or upcoding.
(C)
Altering dates of service.
(D)
Double billing or excessive billing.
(2)
Forgery of a document or record with the intent to deceive or gain benefits, which includes, but is not limited to:
(A)
Creating or altering a fictitious document, signature, medical record, or prescription to make them appear genuine.
(B)
Submitting a falsified academic record, transcript, diploma, or certification with the intent to gain employment.
(3)
Use of a fabricated address as a service location.
(4)
Improper determination of eligibility for hospice care to a patient.
(5)
Record of a felony conviction.
(6)
Violation of patient data and federal and state privacy laws, including, but not limited to, the Health Insurance Portability and Accountability Act (HIPAA), Confidentiality of Medical Information Act (CMIA), and Information Practices Act (IPA).
(7)
Abusive or negligent conduct towards patients, resulting in either inadequate care or immediate jeopardy.
(c)
An applicant has the right to appeal a denial of licensure by presenting a written request for a hearing pursuant to Health and Safety Code section 131071. To contest the Department's denial of licensure, the applicant must submit a written petition to the Department within 15 days after service of the Department's notice of denial of licensure. Upon receipt of such petition, the matter will be set for hearing pursuant to California Government Code section 11504. Absent a final decision, which overturns the Department's denial of licensure, any further licensure or certification activity will require the hospice to submit a new application for licensure.
Source outline
25 anchors in this source