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Title: Section 504.4 - Duties of the department.

504.4 Duties of the department. (a) Upon receipt of a complete, original and signed application, an investigation will be conducted to verify or supplement the information contained in the application. The background and qualifications of the applicant shall also be reviewed.

(b) The department may request further information from an applicant. In such a case, it shall make a clear and precise request to the applicant for the information and inform the applicant whether or not action on the application will be postponed pending receipt of the requested information. Delay occasioned by the applicant's failure to timely reply shall not be counted in calculating the time within which the department shall make its determination on the application.

(c) The department shall complete its investigation and determine whether or not to enroll the applicant within 90 calendar days after receipt of an application.

(d) If an applicant cannot be fully investigated within 90 days, the department may extend the time for acting on an application for up to 120 calendar days from the date of receipt of the application. Written notice of this extension will be mailed to the applicant within 60 calendar days from the time the application was received.

(e) Upon completion of its consideration of an application, the department shall either:

(1) enroll the applicant as a provider; or

(2) deny the application, if it is in the best interest of the medical assistance program to do so, specifying the reasons for denial.



VOLUME C (Title 18)