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N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers

North DakotaregulationNorth Dakota Department of Human Services (Department of Health and Human Services)

What this rule requires your agency to do

  • 1A QSP must not be debarred, have a professional license/certificate suspended or terminated, or be excluded from Medicare/Medicaid/other federal health care programs (§ 75-03-23-08(8),(12); § 75-03-23-08.1(4)(h),(k)).(N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers)
  • 2A QSP must maintain billing activity within twelve months of enrollment/re-enrollment and must not demonstrate a pattern of absenteeism by failing to provide authorized, agreed-upon care (§ 75-03-23-08.1(4)(n)-(o); § 75-03-23-08(14)-(15)).(N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers)
  • 3The Department may require provider education or a business integrity agreement prior to imposing sanctions and may impose sanctions for reasons under § 75-02-05-05 (§ 75-03-23-08.1(1),(3)).(N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers)
  • 4A QSP must remain in compliance with applicable state laws, state regulations, program issuances, application/provider-agreement terms, and provider certification terms on submitted claims, or face denial/termination (§ 75-03-23-08(2)-(4); § 75-03-23-08.1(4)(b)-(d)).(N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers)
  • 5A QSP must not demonstrate a pattern of submitting inaccurate billings/cost reports or billings for services not covered under department programs (§ 75-03-23-08(6)-(7); § 75-03-23-08.1(4)(f)-(g)).(N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers)
  • 6A QSP must repay or arrange repayment of identified overpayments or erroneous payments (§ 75-03-23-08.1(4)(m); § 75-03-23-08(11)).(N.D. Admin. Code §§ 75-03-23-08 and 75-03-23-08.1 - Denial of Application, Sanctions and Termination of Qualified Service Providers)

Applies to: personal care

Sets the grounds on which the Department may deny a QSP application and the sanctions/termination the Department may impose against an enrolled QSP, including for noncompliance with laws, billing patterns, exclusions, inactivity, and absenteeism.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.