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NCDHHS Policies and Manuals  >  Health Benefits/NC Medicaid  >  Family and Children’s Medicaid

MA-3535 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES

I. PURPOSE
II. LEGAL RESPONSIBILITY AND REFERENCES
III. NORTH CAROLINA GENERAL STATUTES
IV. FRAUD VS. MISREPRESENTATION
V. PREVENTION
VI. DETECTION
VII. INVESTIGATIONS
VIII. CALCULATING OVERPAYMENTS
IX. NORTH CAROLINA HEALTH CHOICE OVERPAYMENTS
X. CONCLUSIONS AND RECOMMENDATIONS
XI. NOTICES & APPEALS
XII. ADMINISTRATIVE COLLECTION PROCEDURES
XIII. BANKRUPTCY
XIV. DISTRIBUTION OF CASH REPAYMENT
XV. EPICS REPORTING REQUIREMENTS
XVI. NC DEBT SETOFF (TAX INTERCEPT) CRITERIA FOR MEDICAID CLAIMS
XVII. NORTH CAROLINA EDUCATIONAL LOTTERY INTERCEPTIONS
XVIII. NORTH CAROLINA TITLE XIX MEDICAID/NCHC RECIPIENT PROFILES
XIX. CITATIONS AND REFERENCES

Document Category: Family and Children’s Medicaid

  • MA-3535 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES

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