Section He-W 520.05 - Fraud Detection and Investigation(a) In accordance with 42 CFR 455.14, if the department receives a complaint of medicaid fraud or abuse from any source or identifies any questionable practices, it shall conduct a preliminary investigation.(b) Cases where potential fraud has been detected as a result of a preliminary investigation pursuant to (a) above, shall be referred for a full investigation to the appropriate agency, in accordance with 42 CFR 455.15.(c) A full investigation and resolution shall be conducted in accordance with 42 CFR 455.16.N.H. Admin. Code § He-W 520.05
(See Revision Note at chapter heading He-W 500); ss by #6574, eff 9-12-97; ss by #6925, eff 1-1-99; ss by #8781, eff 1-1-07
Amended byVolume XXXV Number 06, Filed February 12, 2015, Proposed by #10776, Effective 1/31/2015, Expires7/30/2015.Amended by Volume XXXV Number 32, Filed August 13, 2015, Proposed by #10887, Effective 7/17/2015, Expires7/17/2025.