[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR1007.17]



[Page 1209-1210]

 

                         TITLE 42--PUBLIC HEALTH

 

      GENERAL--HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

PART 1007_STATE MEDICAID FRAUD CONTROL UNITS--Table of Contents

 

Sec.  1007.17  Annual report.



    At least 60 days prior to the expiration of the certification 

period, the unit will submit to the Secretary a report covering the last 

12 months (the first 9 months of the certification period for the first 

annual report), and containing the following information--

    (a) The number of investigations initiated and the number completed 

or closed, categorized by type of provider;

    (b) The number of cases prosecuted or referred for prosecution; the 

number of cases finally resolved and their outcomes; and the number of 

cases investigated but not prosecuted or referred for prosecution 

because of insufficient evidence;

    (c) The number of complaints received regarding abuse and neglect of 

patients in health care facilities; the



[[Page 1210]]



number of such complaints investigated by the unit; and the number 

referred to other identified State agencies;

    (d) The number of recovery actions initiated by the unit; the number 

of recovery actions referred to another agency; the total amount of 

overpayments identified by the unit; and the total amount of 

overpayments actually collected by the unit;

    (e) The number of recovery actions initiated by the Medicaid agency 

under its agreement with the unit, and the total amount of overpayments 

actually collected by the Medicaid agency under this agreement;

    (f) Projections for the succeeding 12 months for items listed in 

paragraphs (a) through (e) of this section;

    (g) The costs incurred by the unit; and

    (h) A narrative that evaluates the unit's performance; describes any 

specific problems it has had in connection with the procedures and 

agreements required under this part; and discusses any other matters 

that have impaired its effectiveness.



(Approved by the Office of Management and Budget under control number 

0990-0162)