Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1705 - MEDICAL ASSISTANCE RECOVERY
Subchapter 6 - RECOVERY OF OVERPAYMENT TO PROVIDERS
Section 17-1705-45 - Recoupment of overpayment to providers
Universal Citation: HI Admin Rules 17-1705-45
Current through August, 2024
(a) The department shall recoup overpayment to providers when overpayment occurred for reasons including, but not limited to one of the following:
(1) Ineligible provider;
(2) Noncovered service;
(3) Noncovered drug;
(4) No approved prior authorization when a
service requires one;
(5) Incorrect
payment allowance identified through post payment review by department staff;
or
(6) Claim processing
error.
(b) The responsibility of recoupment may be assigned to the fiscal agent with whom the department has a contract.
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