249A.45 Provider’s third-party submissions.
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.
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.
2013 Acts, ch 24, §9
Structure Iowa Code
Chapter 249A - MEDICAL ASSISTANCE
Section 249A.3A - Medical assistance — all income-eligible children.
Section 249A.4 - Duties of director.
Section 249A.4A - Garnishment.
Section 249A.4B - Medical assistance advisory council.
Section 249A.5 - Recovery of payment.
Section 249A.6 - Assignment — lien.
Section 249A.6A - Restitution.
Section 249A.7 - Fraudulent practices — investigations and audits — Medicaid fraud fund.
Section 249A.8 - Fraudulent practice.
Section 249A.11 - Payment for patient care segregated.
Section 249A.12 - Assistance to persons with an intellectual disability.
Section 249A.14 - County attorney to enforce.
Section 249A.15 - Licensed psychologists eligible for payment — provisional licensees.
Section 249A.15B - Speech pathologists eligible for payment.
Section 249A.16 - New rates for services — effective date.
Section 249A.17 - Transitional medical assistance.
Section 249A.18A - Resident assessment.
Section 249A.19 - Health care facilities — penalty.
Section 249A.20 - Noninstitutional health providers — reimbursement.
Section 249A.20A - Preferred drug list program.
Section 249A.20B - Nursing facility quality assurance assessment.
Section 249A.24 - Iowa medical assistance drug utilization review commission — created.
Section 249A.27 - Indemnity for case management and disallowed costs.
Section 249A.29 - Home and community-based services waiver providers — records checks.
Section 249A.30A - Medical assistance — personal needs allowance.
Section 249A.32A - Home and community-based services waivers — limitations.
Section 249A.32B - Early and periodic screening, diagnosis, and treatment funding.
Section 249A.33 - Pharmaceutical settlement account — medical assistance program.
Section 249A.34 - Medical assistance crisis intervention team.
Section 249A.36 - Medical assistance quality improvement council.
Section 249A.37 - Health care information sharing.
Section 249A.38 - Inmates of public institutions — suspension of medical assistance.
Section 249A.39 - Reporting of overpayment.
Section 249A.40 - Involuntarily dissolved providers — overpayments or incorrect payments.
Section 249A.41 - Overpayment — interest.
Section 249A.42 - Overpayment — limitations periods.
Section 249A.43 - Provider overpayment — notice — judgment.
Section 249A.44 - Overpayment — emergency relief.
Section 249A.45 - Provider’s third-party submissions.
Section 249A.46 - Liability of other persons — repayment of claims.
Section 249A.48 - Temporary moratoria.
Section 249A.49 - Internet site — providers found in violation of medical assistance program.
Section 249A.50 - Fraudulent practices — investigations and audits — Medicaid fraud fund.
Section 249A.51 - Fraudulent practice.
Section 249A.52 - Garnishment.
Section 249A.53 - Recovery of payment.
Section 249A.54 - Assignment — lien.
Section 249A.55 - Restitution.