Section 296-20-01070. Waiting periods for reapplying to the network.

(1) Providers are not eligible to reapply for enrollment in the network if they have been denied or removed from network participation due to:

(a) A finding of risk of harm, pursuant to WAC 296-20-01100;

(b) Having been excluded, expelled or suspended, other than for convenience, from any federally or state funded programs including, but not limited to, medicare or medicaid programs;

(c) Having been convicted of a felony or pled guilty to a felony for a crime and the felony has not been expunged from the provider's record including, but not limited to, health care fraud, patient abuse and the unlawful manufacture, distribution, prescription or dispensing of controlled substances;

(d) Sexual misconduct as defined in profession specific rules of any state or jurisdiction, including Washington state department of health.

(2) Providers who are denied or removed from the network or terminated for any other reason than those set forth in subsection (1) of this section are not eligible to reapply for enrollment in the network for five years. The department may grant an exception where the reason for denial or removal is related to pending actions or charges which have been resolved or deemed by the department to be minor or clerical in nature.

[Statutory Authority: RCW 51.36.010, 51.04.020, and 51.04.030. WSR 12-02-058, § 296-20-01070, filed 1/3/12, effective 2/3/12.]

RCW 51.36.010, 51.04.020, and 51.04.030. WSR 12-02-058, § 296-20-01070, filed 1/3/12, effective 2/3/12.

Rules

296-20-01100,