42 C.F.R. § 455.1 Basis and scope.
Title 42 - Public Health
This part sets forth requirements for a State fraud detection and investigation program, and for disclosure of information on ownership and control. (a) Under the authority of sections 1902(a)(4), 1903(i)(2), and 1909 of the Social Security Act, Subpart A provides State plan requirements for the identification, investigation, and referral of suspected fraud and abuse cases. In addition, the subpart requires that the State— (1) Report fraud and abuse information to the Department; and (2) Have a method to verify whether services reimbursed by Medicaid were actually furnished to recipients. (b) Subpart B implements sections 1124, 1126, 1902(a)(36), 1903(i)(2), and 1903(n) of the Act. It requires that providers and fiscal agents must agree to disclose ownership and control information to the Medicaid State agency. [51 FR 34787, Sept. 30, 1986]
Title 42: Public Health
PART 455—PROGRAM INTEGRITY: MEDICAID
§ 455.1 Basis and scope.
