N.H. Code Admin. R. He-W 569.07
Utilization Review and Control
Effective Jun 24, 2025(See Revision Note at chapter heading He-W 500); ss by #6575, eff 9-12-97; ss by #8400, INTERIM, eff 8-20-05, EXPIRES: 2-16-06; #8562, eff 2-7-06; ss by #10517, eff 2-7-14, EXPIRED: 2-7-24 New. #14277, eff 6-24-25, EXPIRES: 6-24-35Former Division of Human Services
- (a) The department’s bureau of program integrity shall monitor utilization of radiological services, to identify, prevent, and correct potential occurrences of fraud, waste, and abuse, in accordance with 42 CFR 455, 42 CFR 456, He-W 520, and He-W 521.
- (b) The department shall recoup state and federal medicaid payments as permitted by 42 CFR 455, 42 CFR 447, and 42 CFR 456 for a provider’s failure to maintain supporting records in accordance with He-W 520, He-W 521, and He-W 569.
Source. (See Revision Note at chapter heading He-W 500); ss by #6575, eff 9-12-97; ss by #8400, INTERIM, eff 8-20-05, EXPIRES: 2-16-06; #8562, eff 2-7-06; ss by #10517, eff 2-7-14, EXPIRED: 2-7-24 New. #14277, eff 6-24-25, EXPIRES: 6-24-35