MA-2900 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES

MA-2900 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES

  1. PURPOSE
  2. LEGAL RESPONSIBILITY AND REFERENCES
  3. NORTH CAROLINA GENERAL STATUTES
  4. FRAUD VS. MISREPRESENTATION
  5. PREVENTION
  6. DETECTION
  7. INVESTIGATIONS
  8. CALCULATING OVERPAYMENTS
  9. CONCLUSIONS AND RECOMMENDATIONS
  10. NOTICES AND APPEALS
  11. ADMINISTRATIVE COLLECTION PROCEDURES
  12. BANKRUPTCY
  13. DISTRIBUTION OF CASH REPAYMENT
  14. EPICS REPORTING REQUIREMENTS
  15. NC DEBT SETOFF (TAX INTERCEPT) CRITERIA FOR MEDICAID CLAIMS
  16. NORTH CAROLINA TITLE XIX MEDICAID RECIPIENT/NCHC PROFILES