[Code of Federal Regulations]
[Title 42, Volume 3]
[Revised as of October 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR1007.7]

[Page 1182-1183]
 
                         TITLE 42--PUBLIC HEALTH
 
                     CHAPTER V--OFFICE OF INSPECTOR
                          GENERAL--HEALTH CARE,
                        DEPARTMENT OF HEALTH AND
                             HUMAN SERVICES
 
PART 1007--STATE MEDICAID FRAUD CONTROL UNITS--Table of Contents
 
Sec. 1007.7  Organization and location requirements.

    Any of the following three alternatives is acceptable:
    (a) The unit is located in the office of the State Attorney General 
or another department of State government which has Statewide authority 
to prosecute individuals for violations of criminal laws with respect to 
fraud in the provision or administration of medical assistance under a 
State plan implementing title XIX of the Act;
    (b) If there is no State agency with Statewide authority and 
capability for criminal fraud prosecutions, the unit has established 
formal procedures that assure that the unit refers suspected cases of 
criminal fraud in the State Medicaid program to the appropriate State 
prosecuting authority or authorities, and provides assistance and 
coordination to such authority or authorities in the prosecution of such 
cases; or

[[Page 1183]]

    (c) The unit has a formal working relationship with the office of 
the State Attorney General and has formal procedures for referring to 
the Attorney General suspected criminal violations occurring in the 
State Medicaid program and for effective coordination of the activities 
of both entities relating to the detection, investigation and 
prosecution of those violations. Under this requirement, the office of 
the State Attorney General must agree to assume responsibility for 
prosecuting alleged criminal violations referred to it by the unit. 
However, if the Attorney General finds that another prosecuting 
authority has the demonstrated capacity, experience and willingness to 
prosecute an alleged violation, he or she may refer a case to that 
prosecuting authority, as long as the Attorney General's Office 
maintains oversight responsibility for the prosecution and for 
coordination between the unit and the prosecuting authority.