§ 455.13 - Methods for identification, investigation, and referral.  


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  • § 455.13 Methods for identification, investigation, and referral.

    The Medicaid agency must have -

    (a) Methods and criteria for identifying suspected fraud cases;

    (b) Methods for investigating these cases that -

    (1) Do not infringe on the legal rights of persons involved; and

    (2) Afford due process of law; and

    (c) Procedures, developed in cooperation with State legal authorities, for referring suspected fraud cases to law enforcement officials.

    [43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3755, Jan. 27, 1983]