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Code of Federal Regulations Title 42. Public Health § 42.455.16 Resolution of full investigation

Current as of January 02, 2025 | Updated by Findlaw Staff

A full investigation must continue until—

(a) Appropriate legal action is initiated;

(b) The case is closed or dropped because of insufficient evidence to support the allegations of fraud or abuse;  or

(c) The matter is resolved between the agency and the provider or beneficiary. This resolution may include but is not limited to—

(1) Sending a warning letter to the provider or beneficiary, giving notice that continuation of the activity in question will result in further action;

(2) Suspending or terminating the provider from participation in the Medicaid program;

(3) Seeking recovery of payments made to the provider;  or

(4) Imposing other sanctions provided under the State plan.

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Cite this article: FindLaw.com - Code of Federal Regulations Title 42. Public Health § 42.455.16 Resolution of full investigation - last updated January 02, 2025 | https://codes.findlaw.com/cfr/title-42-public-health/cfr-sect-42-455-16/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

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