N.H. Code Admin. R. He-W 513.07
Utilization Review and Control
Effective Nov 27, 2018#10655, INTERIM, eff 8-15-14, EXPIRES: 2-11-15; ss by #10779, eff 2-11-15; ss by #10922, eff 9-1-15; ss by #11107, eff 7-1-16; ss by #12681, eff 11-27-18; ss by #12681, eff 11-27-18Former Division of Human Services
- (a) The department’s provider program integrity unit shall monitor utilization of SUD treatment services to identify, prevent, and correct potential occurrences of fraud, waste, and abuse, in accordance with 42 CFR 455, 42 CFR 456, and He-W 520.
- (b) Failure to maintain records in accordance with He-W 520 and He-W 513 shall entitle the department to recoupment of state and federal medicaid payments made as permitted by 42 CFR 455, 42 CFR 447, and 42 CFR 456.
Source. #10655, INTERIM, eff 8-15-14, EXPIRES: 2-11-15; ss by #10779, eff 2-11-15; ss by #10922, eff 9-1-15; ss by #11107, eff 7-1-16; ss by #12681, eff 11-27-18; ss by #12681, eff 11-27-18