[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: 42CFR455.17]



[Page 334]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 455_PROGRAM INTEGRITY: MEDICAID--Table of Contents

 

   Subpart A_Medicaid Agency Fraud Detection and Investigation Program

 

Sec.  455.17  Reporting requirements.



    The agency must report the following fraud or abuse information to 

the appropriate Department officials at intervals prescribed in 

instructions.

    (a) The number of complaints of fraud and abuse made to the agency 

that warrant preliminary investigation.

    (b) For each case of suspected provider fraud and abuse that 

warrants a full investigation--

    (1) The provider's name and number;

    (2) The source of the complaint;

    (3) The type of provider;

    (4) The nature of the complaint;

    (5) The approximate range of dollars involved; and

    (6) The legal and administrative disposition of the case, including 

actions taken by law enforcement officials to whom the case has been 

referred.



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

0938-0076)



[43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3756, Jan. 27, 1983]