|
Home Page > Executive Branch > Code of Federal Regulations > Electronic Code of Federal Regulations
e-CFR Data is current as of February 4, 2010
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
|
| Other applicable regulations. |
|
Subpart A--MEDICAID AGENCY FRAUD DETECTION AND INVESTIGATION PROGRAM
|
| Methods for identification, investigation, and referral. |
|
|
| Preliminary investigation. |
|
|
| Resolution of full investigation. |
|
|
| Provider's statements on claims forms. |
|
|
| Provider's statement on check. |
|
|
| Recipient verification procedure. |
|
|
| Cooperation with State Medicaid fraud control units. |
|
|
| Withholding of payments in cases of fraud or willful misrepresentation. |
|
Subpart B--DISCLOSURE OF INFORMATION BY PROVIDERS AND FISCAL AGENTS
|
| Determination of ownership or control percentages. |
|
|
| Disclosure by providers and fiscal agents: Information on ownership and control. |
|
|
| Disclosure by providers: Information related to business transactions. |
|
|
| Disclosure by providers: Information on persons convicted of crimes. |
|
Subpart C--MEDICAID INTEGRITY PROGRAM
|
| Limitation on contractor liability. |
|
|
| Eligibility requirements. |
|
|
| Medicaid integrity audit program contractor functions. |
|
|
| Conflict of interest resolution. |
|
Subpart D--INDEPENDENT CERTIFIED AUDIT OF STATE DISPROPORTIONATE SHARE HOSPITAL PAYMENT ADJUSTMENTS
|
| Condition for Federal financial participation (FFP). |
|
|
