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Title 42: Public Health
CHAPTER IV: CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)
SUBCHAPTER C: MEDICAL ASSISTANCE PROGRAMS
PART 455: PROGRAM INTEGRITY: MEDICAID
Subpart A: Medicaid Agency Fraud Detection and Investigation Program
455.17 - Reporting requirements.
The agency must report the following fraud or abuse information to the appropriate Department officials at intervals prescribed in instructions.
(a) The number of complaints of fraud and abuse made to the agency that warrant preliminary investigation.
(b) For each case of suspected provider fraud and abuse that warrants a full investigation?
(1) The provider's name and number;
(2) The source of the complaint;
(3) The type of provider;
(4) The nature of the complaint;
(5) The approximate range of dollars involved; and
(6) The legal and administrative disposition of the case, including actions taken by law enforcement officials to whom the case has been referred.
(Approved by the Office of Management and Budget under control number 0938-0076)
[43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3756, Jan. 27, 1983]
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