Methods for identification, investigation, and referral.

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medical Assistance Programs
  6. Program Integrity: Medicaid
  7. Medicaid Agency Fraud Detection and Investigation Program
  8. Methods for identification, investigation, and referral.

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§ 455.13 Methods for identification, investigation, and referral.

The Medicaid agency must have -

(a) Methods and criteria for identifying suspected fraud cases;

(b) Methods for investigating these cases that -

(1) Do not infringe on the legal rights of persons involved; and

(2) Afford due process of law; and

(c) Procedures, developed in cooperation with State legal authorities, for referring suspected fraud cases to law enforcement officials.

[43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3755, Jan. 27, 1983]


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