C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 455—PROGRAM INTEGRITY: MEDICAID › Subpart A—Medicaid Agency Fraud Detection and Investigation Program

42 C.F.R. § 455.14

Preliminary investigation

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If the agency receives a complaint of Medicaid fraud or abuse from any source or identifies any questionable practices, it must conduct a preliminary investigation to determine whether there is sufficient basis to warrant a full investigation.

[48 FR 3756, Jan. 27, 1983]
Notes of Decisions
Cited in 2 cases, 2003–2019 · leading case: State v. Chalice Renee Zeitner
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State v. Chalice Renee Zeitner (2019) ariz “Furthermore, state Medicaid agencies must conduct internal investigations of any report of fraud, 42 C.F.R. § 455.14 , and must refer suspected provider or beneficiary fraud to the state's fraud control unit or "appropriate law enforcement agency," respectively, 42 C.”
Patrick M. Hays v. Luverne Hoffman (2003) ca8 “” 42 C.F.R. §§ 455.14 , 455.15(a); see also minn.”
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