Iowa Code 249A.45 – Provider’s third-party submissions
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1. The department may refuse to accept a financial and statistical report, cost report, or any other submission from any third party acting under a provider‘s authority or direction to prepare or submit such documents or information, for good cause shown. For the purposes of this section, “good cause” includes but is not limited to a pattern or practice of submitting unallowable costs on cost reports; making a false statement or certification to the director or any representative of the department; professional negligence or other demonstrated lack of knowledge of the cost reporting process; conviction under a federal or state law relating to the operation of a publicly funded program; or submission of a false claim under chapter 685.
Terms Used In Iowa Code 249A.45
- Conviction: A judgement of guilt against a criminal defendant.
- Department: means the department of health and human services. See Iowa Code 249L.2
- Department: means the department of health and human services. See Iowa Code 249A.2
- Director: means the director of health and human services. See Iowa Code 249A.2
- Party: means a petitioner, a respondent, or a person who intervenes in a proceeding instituted under this chapter. See Iowa Code 252A.2
- Provider: means an individual, firm, corporation, association, or institution which is providing or has been approved to provide medical assistance to recipients under this chapter. See Iowa Code 249A.2
- state: when applied to the different parts of the United States, includes the District of Columbia and the territories, and the words "United States" may include the said district and territories. See Iowa Code 4.1
2. If the department refuses to accept a cost report from a third party for good cause under this section, the third party shall be strictly liable to the provider for all fees incurred in preparation of the cost report, as well as reasonable attorney fees and costs. The department shall not take any adverse action against a provider that results from the unintentional delay in the submission of a new cost report or other submission necessitated by the department’s refusal to accept a cost report or other submission under this section. The department shall notify an affected provider within seven business days of any refusal to accept a cost report.