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 531 - PHYSICIAN SERVICES
Section He-W 531.08 - Utilization Review and Control
Universal Citation: NH Admin Rules He-W 531.08
Current through Register No. 40, October 3, 2024
(a) The department's provider integrity unit shall monitor utilization of physician services, to identify, prevent, and correct potential occurrences of fraud, waste, and abuse, in accordance with 42 CFR 455, CFR 456, 42 CFR 1001, and He-W 520.
(b) The department shall recoup state and federal medicaid payments as permitted by 42 CFR 455, 42 CFR 447, and 42 CFR 456 for a provider's failure to maintain supporting records in accordance with He-W 520 and He-W 531.
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