42 C.F.R. PART 455--PROGRAM INTEGRITY: MEDICAID
TITLE 42--Public Health
CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
SUBCHAPTER C--MEDICAL ASSISTANCE PROGRAMS
PART 455--PROGRAM INTEGRITY: MEDICAID
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| Other applicable regulations.
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Subpart A--MEDICAID AGENCY FRAUD DETECTION AND INVESTIGATION PROGRAM
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| Methods for identification, investigation, and referral.
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| Preliminary investigation.
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| Resolution of full investigation.
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| Provider's statements on claims forms.
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| Provider's statement on check.
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| Recipient verification procedure.
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| Cooperation with State Medicaid fraud control units.
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| Withholding of payments in cases of fraud or willful misrepresentation.
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Subpart B--DISCLOSURE OF INFORMATION BY PROVIDERS AND FISCAL AGENTS
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| Determination of ownership or control percentages.
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| Disclosure by providers and fiscal agents: Information on ownership and control.
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| Disclosure by providers: Information related to business transactions.
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| Disclosure by providers: Information on persons convicted of crimes.
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