Pol-0277-1 Provider Program Violations

Effective date: 10/1/2018

See also: WAC 110-15-0277, WAC 110-15-0279, WAC 110-15-0034, and WAC 110-15-0003

Revisions: Policy Manual Revision Log

Policy

This policy applies when providers do not comply with the provider responsibilities

  1. A program violation occurs any time a provider fails to comply with the provider’s responsibilities as outlined in WAC 110-15-0034 and the failure results in an overpayment. 
    1. When the overpayment is removed through the administrative hearing process or a supervisory review it does not count as a program violation.
    2. Program violations for failure to submit attendance records, prior to billing, may not result in an overpayment.
  2. Technical assistance on billing rules and procedures is offered by DCYF’s quality assurance team on any provider program violation.
  3. On the fourth program violation, providers are reviewed by DCYF’s quality assurance team for potential sanction.