Ala. Admin. Code r. 560-X-4-.02

Current through Register Vol. 43, No. 3, December 31, 2024

Section 560-X-4-.02 - Purpose

The purpose of the Program Integrity Division is:

(1) To guard against fraud, waste, and/or abuse of Medicaid program benefits by individual providers and recipients;

(2) To assure that Medicaid recipients receive necessary medical care at a level of quality consistent with that available to general population;

(3) To exercise necessary fiscal control over federal and state tax dollars;

(4) To assure provider and recipient compliance with federal and state Medicaid rules and regulations; and

(5) To assist in the identification of claims processing procedures that may be in conflict with State policy.

Ala. Admin. Code r. 560-X-4-.02

Rule effective October 1, 1982. Amended: effective November 10, 1988. Repealed and Replaced: Filed February 7, 1994; effective March 15, 1994.

Amended by Alabama Administrative Monthly Volume XXXVI, Issue No. 12, September 28, 2018, eff. 10/26/2018.

Author: Jacqueline G. Thomas, Director, Program Integrity Division

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §§ 431, 455, 456, 1000, 1001, 1002 ; State Medical Manual 11420.6M.