North Carolina Administrative Code (Last Updated: November 13, 2014) |
TITLE 10A. HEALTH AND HUMAN SERVICES |
CHAPTER 22. MEDICAL ASSISTANCE ELIGIBILITY |
SUBCHAPTER F. PROGRAM INTEGRITY |
10A NCAC 22F .0601. RECOUPMENT
Latest version.
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(a) The Medicaid Agency will seek full restitution of any and all improper payments made to providers by the Medicaid Program. Recovery may be by lump sum payment, by a negotiated payment schedule not to exceed one year or by withholding from the provider's pending claims the total or a portion of the recoupment amount.
(b) A provider may argue all or a part of a recoupment imposed by the Medicaid Agency by requesting a Reconsideration Review of the investigative findings and, thereafter, an Executive Decision.
History Note: Authority G.S. 108A‑25(b); 42 C.F.R. Part 431; 42 C.F.R. Part 455; 42 C.F.R. Part 456;
Eff. February 1, 1982;
Amended Eff. May 1, 1984.