WILLIAM DONALD SCHAEFER, Governor                            Ch. 491

(2) (I) A PRIVATE PROVIDER MAY REQUEST AN ADMINISTRATIVE
RESOLUTION OF A BILLING RATE SET UNDER PARAGRAPH (1) OF THIS SUBSECTION.

(II)     WITHIN 30 60 DAYS AFTER RECEIPT OF THE PROVIDER'S
REQUEST, THE ADMINISTRATION SHALL MAKE A DECISION ON THE REQUEST FOR
AN ADMINISTRATIVE RESOLUTION.

(III)    IF AN ADMINISTRATIVE RESOLUTION CAN NOT CANNOT BE
REACHED BETWEEN THE PROVIDER AND THE ADMINISTRATION, THE PROVIDER
MAY REQUEST AN EVIDENTIARY HEARING OR AN ORAL HEARING IN ACCORDANCE
WITH REGULATIONS OF THE DEPARTMENT.

(C)     SUBJECT TO THE PROVISIONS OF SUBSECTIONS (D), (E), AND (F) OF THIS
SECTION, THE ADMINISTRATION SHALL PROVIDE PAYMENT TO PRIVATE
PROVIDERS FOR THE SERVICES PROVIDED FROM THE FUNDS DESIGNATED IN
SUBSECTION (B) OF THIS SECTION IN ACCORDANCE WITH THE FOLLOWING
PAYMENT SCHEDULE:

(1)      ON OR BEFORE THE THIRD BUSINESS DAY OF THE FISCAL QUARTER
BEGINNING JULY 1, 33% OF THE TOTAL ANNUAL AMOUNT TO BE PAID TO THE
PROVIDER;

(2)      ON OR BEFORE THE THIRD BUSINESS DAY OF THE FISCAL QUARTER
BEGINNING OCTOBER 1, 25% OF THE TOTAL ANNUAL AMOUNT TO BE PAID TO THE
PROVIDER;

(3)      ON OR BEFORE THE THIRD BUSINESS DAY OF THE FISCAL QUARTER
BEGINNING JANUARY 1, 25% OF THE TOTAL ANNUAL AMOUNT TO BE PAID TO THE
PROVIDER; AND

(4)      ON OR BEFORE THE THIRD BUSINESS DAY OF THE FISCAL QUARTER
BEGINNING APRIL 1, 17% OF THE TOTAL ANNUAL AMOUNT TO BE PAID TO THE
PROVIDER.

(D)     THE ADMINISTRATION MAY DEVIATE FROM THE PAYMENT SCHEDULE
PROVIDED UNDER SUBSECTION (C) OF THIS SECTION FOR ANY PROVIDER:

(1)      THAT IS REIMBURSED THROUGH THE PROSPECTIVE PAYMENT
SYSTEM AND FAILS TO SUBMIT PROPERLY COMPLETED PROGRAM ATTENDANCE
REPORTS WITHIN 15 DAYS OF THE BEGINNING OF EACH MONTH; OR

(2)      THAT PROVIDES SERVICES UNDER THE MEDICAL ASSISTANCE
PROGRAM AND FAILS TO SUBMIT THE DESIGNATED FORMS USED BY THE MEDICAL
ASSISTANCE PROGRAM TO CLAIM FEDERAL FUND PARTICIPATION WITHIN 30 DAYS
AFTER THE END OF EACH MONTH.

(E)     A DEVIATION FROM THE PAYMENT SCHEDULE AS PROVIDED UNDER
SUBSECTION (D) OF THIS SECTION MAY OCCUR ONLY IF THE ADMINISTRATION HAS:

(1) ADVISED THE PROVIDER THAT:

(I) AN ATTENDANCE REPORT WHICH HAS BEEN SUBMITTED ON
TIME IS IN NEED OF CORRECTION; OR

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