Chapter 16 - PROGRAM INTEGRITY
- Section 16-1 - Authority
- Section 16-2 - Purpose and Applicability
- Section 16-3 - Definitions
- Section 16-4 - Investigation of Suspected Fraud, Theft, or Abuse of Services by Providers
- Section 16-5 - Investigation of Suspected Fraud, Theft, or Abuse of Services by Clients
- Section 16-6 - Medical, Financial, and Patient Records
- Section 16-7 - Audits
- Section 16-8 - Random Sample and Extrapolation
- Section 16-9 - Sanctions for Providers
- Section 16-10 - Sanctions for Clients
- Section 16-11 - Educational Intervention
- Section 16-12 - Recovery of Overpayments from Providers
- Section 16-13 - Postpayment Review of All Claims Submitted by the Provider
- Section 16-14 - Prepayment Review of All Claims Submitted by the Provider
- Section 16-15 - Suspension of Payments
- Section 16-16 - Suspension of Provider Agreement
- Section 16-17 - Termination of Provider Agreement
- Section 16-18 - Conditional Future Provider Agreement
- Section 16-19 - Additional Sanctions
- Section 16-20 - Reconsideration
- Section 16-21 - Administrative Hearing
- Section 16-22 - Suspending or Withholding Payments Pending Reconsideration or Administrative Hearing
- Section 16-23 - Remedies Cumulative
- Section 16-24 - Effect of Fraud, Theft, or Abuse of Services of Medicare
- Section 16-25 - Disposition of Recovered Funds
- Section 16-26 - Delegation of Duties
- Section 16-27 - Interpretation of Chapter
- Section 16-28 - Superseding Effect
- Section 16-29 - Severability