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Title: Section 518.1 - Scope.

Section 518.1 Scope. (a) This Part sets forth the procedures for the recovery of overpayments determined to be due the department under the medical assistance program and for withholding payments otherwise due a provider.

(b) When the department has determined that any person has submitted or caused to be submitted claims for medical care, services or supplies for which payment should not have been made, it may require repayment of the amount determined to have been overpaid.

(c) An overpayment includes any amount not authorized to be paid under the medical assistance program, whether paid as the result of inaccurate or improper cost reporting, improper claiming, unacceptable practices, fraud, abuse or mistake.

(d) Recovery of overpayments may be made in connection with an audit, review or investigation under Part 515 or 517 of this Title, or in connection with other reviews or audits by authorized local, State or Federal agencies available to the department.



VOLUME C (Title 18)