New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-W - Former Division of Human Services
Chapter He-W 500 - MEDICAL ASSISTANCE
Part He-W 520 - GENERAL PROGRAM INFORMATION
Section He-W 520.05 - Fraud Detection and Investigation

Universal Citation: NH Admin Rules He-W 520.05

Current through Register No. 40, October 3, 2024

(a) In accordance with 42 CFR 455.14, if the department receives a complaint of medicaid fraud or abuse from any source or identifies any questionable practices, it shall conduct a preliminary investigation.

(b) Cases where potential fraud has been detected as a result of a preliminary investigation pursuant to (a) above, shall be referred for a full investigation to the appropriate agency, in accordance with 42 CFR 455.15.

(c) A full investigation and resolution shall be conducted in accordance with 42 CFR 455.16.

(See Revision Note at chapter heading He-W 500); ss by #6574, eff 9-12-97; ss by #6925, eff 1-1-99; ss by #8781, eff 1-1-07

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