Section 182-520-0005 - Washington apple health fraud referrals and overpayments(1) The agency or the agency's designee may refer a case to the office of fraud and accountability for a fraud investigation when it has reliable information that the person purposely misrepresented their circumstances in order to qualify for Washington apple health .(2) When a fraud investigation reveals substantial evidence to support a finding of fraud, the case is referred for prosecution. The prosecuting attorney's office decides which cases will be prosecuted.(3) When a referral results in a conviction, an overpayment amount for the cost of the apple health coverage is established.(4) The person is responsible to pay the agency for the amount of overpayment established as a result of a fraud conviction.Wash. Admin. Code § 182-520-0005
Adopted by WSR 14-01-021, filed 12/9/13, effective 1/9/2014Amended by WSR 16-13-059, Filed 6/13/2016, effective 7/14/2016