Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-520 - Fraud referrals and overpayments
Section 182-520-0005 - Washington apple health fraud referrals and overpayments
Current through Register Vol. 24-18, September 15, 2024
(1) The agency or the agency's designee may refer a case to the office of fraud and accountability for a fraud investigation when it has reliable information that the person purposely misrepresented their circumstances in order to qualify for Washington apple health .
(2) When a fraud investigation reveals substantial evidence to support a finding of fraud, the case is referred for prosecution. The prosecuting attorney's office decides which cases will be prosecuted.
(3) When a referral results in a conviction, an overpayment amount for the cost of the apple health coverage is established.
(4) The person is responsible to pay the agency for the amount of overpayment established as a result of a fraud conviction.