32.02.01.26

.26 Findings of Financial Difficulty.

A. Upon a final determination by the Department that a provider is in financial difficulty, the Department shall notify the provider, by certified mail, return receipt requested, of the determination, including whether the Department has determined that there is a significant risk of financial failure.

B. The Department may:

(1) Consult with the Financial Review Committee to review the findings and possible corrective financial plans; and

(2) Assist the provider to develop an adequate corrective financial plan.

C. A provider notified of a determination of financial difficulty shall:

(1) Advise its subscribers of the Department's determination in a meeting to be held by the provider with representatives of the subscribers within 10 days of the provider's receipt of notice from the Department;

(2) Notify the Department in advance of the date, time, and location of the meeting;

(3) Cooperate with the Department to develop a corrective financial plan;

(4) Prepare a 5-year financial plan to correct the causes of the financial difficulty;

(5) Submit the corrective plan to the Department for approval within 60 days of receipt of notification from the Department;

(6) Make available to its subscribers copies of its approved 5-year plan;

(7) Amend the financial plan as the Department may advise to enable a finding of no financial difficulty;

(8) Implement the corrective financial plan;

(9) Submit to the Department within 60 days of the close of each fiscal year an annual progress report on the implementation of its approved financial plan; and

(10) At the direction of the Department, revise and update its corrective financial plan if the Department finds that revisions are necessary based on review of the annual progress report or other investigation.

D. The provider may request from the Secretary a 30-day extension of the 60-day time period specified in §C(5) of this regulation. The Secretary may grant the extension.

E. After a provider has been found to be in financial difficulty, the Department may withhold a renewal certificate of registration or withdraw a current certificate of registration if the Department determines that the provider:

(1) Did not prepare a corrective financial plan within 60 days of notification (or 90 days, if the Secretary granted an extension);

(2) Is unwilling or unable to prepare a corrective financial plan;

(3) Prepared a financial plan which is found by the Department to be inadequate to correct the current or impending financial difficulty; or

(4) Failed to implement the approved corrective plan, which is demonstrated by the annual progress report or an interim investigation by the Department.