Section He-W 536.06 - Utilization Review and Control(a) The department's program integrity unit shall monitor utilization of medical services clinics to identify, prevent, and correct potential occurrences of fraud, waste, and abuse in accordance with 42 CFR 455, 42 CFR 456, 42 CFR 1001, and He-W 520.(b) The department shall recoup state and federal medicaid payments as permitted by 42 CFR 455, 42 CFR 447, and 42 CFR 456 for a provider's failure to maintain supporting records in accordance with He-W 520 and He-W 536.N.H. Admin. Code § He-W 536.06
(See Revision Note at chapter heading He-W 500); ss by #6133, eff 11-30-95; ss by #7825, eff 2-8-03; ss by #9860, eff 2-8-11
Amended by Volume XXXIX Number 10, Filed March 7, 2019, Proposed by #12732, Effective 2/22/2019, Expires 8/21/2019.Amended by Volume XXXIX Number 41, Filed October 10, 2019, Proposed by #12877, Effective 9/25/2019, Expires 9/25/2029.