Under the provisions of federal and state law. Medicaid must establish a mechanism to ensure that all care is of good quality and that the service(s) for which billing was made, conforms to that which was done. See Rule 560-X-2-.01(1) for criteria.
Ala. Admin. Code r. 560-X-17-.08
Author: Jacquelyn King, Program Manager; Medical Support
Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. S401,et seq.