Under the provisions of Federal and State law, Medicaid must establish a mechanism to ensure that all such care is of good quality and that the service(s) for which billing was made, conforms to that which was done. See Chapter 2, Rule 560-X-2-.01(2) and (3) for criteria.

Author: R. Dale Boyles

Statutory Authority: State Plan; 42 C.F.R. §401 et seq.; Title XIX, Social Security Act.

History: Rule effective October 1, 1982. Emergency rule effective June 28, 1991. Amended effective October 12, 1991. Amended: Filed July 7, 1994; effective August 12, 1994.