Current through October 31, 2024
Section 455.16 - Resolution of full investigationA full investigation must continue until-
(a) Appropriate legal action is initiated;(b) The case is closed or dropped because of insufficient evidence to support the allegations of fraud or abuse; or(c) The matter is resolved between the agency and the provider or beneficiary. This resolution may include but is not limited to-(1) Sending a warning letter to the provider or beneficiary, giving notice that continuation of the activity in question will result in further action;(2) Suspending or terminating the provider from participation in the Medicaid program;(3) Seeking recovery of payments made to the provider; or(4) Imposing other sanctions provided under the State plan.43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3756, Jan. 27, 1983