Program Integrity

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. State Children's Health Insurance Programs (SCHIPs)
  6. Allotments and Grants to States
  7. Program Integrity

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Section
457.900

Basis, scope and applicability.

Section
457.910

State program administration.

Section
457.915

Fraud detection and investigation.

Section
457.925

Preliminary investigation.

Section
457.930

Full investigation, resolution, and reporting requirements.

Section
457.935

Sanctions and related penalties.

Section
457.940

Procurement standards.

Section
457.945

Certification for contracts and proposals.

Section
457.950

Contract and payment requirements including certification of payment-related information.

Section
457.960

Reporting changes in eligibility and redetermining eligibility.

Section
457.965

Documentation.

Section
457.980

Verification of enrollment and provider services received.

Section
457.985

Integrity of professional advice to enrollees.

Section
457.990

Provider and supplier screening, oversight, and reporting requirements.