Federal rules previously sanctioned the entire household, even if only one member of the household refused to cooperate with the QC review. New federal rules now apply the sanction for non-cooperation with the QC review to the individual. If it is determined that the entire household is “complicit” with the refusal to cooperate, the sanction shall be applied to the entire household.

The sanction period is also extended from 95 days to 125 days (state) and for refusal to cooperate with the federal QC reviewer from seven months to nine months after the end of the annual review period. These changes are effective beginning October 1, 2011.  [Download]