1305. SUSPENSION OF MEDICAID PAYMENTS FOR OVERPAYMENTS

1305 SUSPENSION OF MEDICAID PAYMENTS FOR OVERPAYMENTS 1305.1 Payments otherwise authorized to be made to a provider under the District of Columbia Medicaid Program may be suspended, in whole or in part, by the Director when either of the following occurs: (a) The Director has detemined that the provider to whom the payments are to be made has been overpaid under Title XIX of the Social Security Act or pertinent federal or District laws and regulations; or (b) DHS has reliable evidence that overpayment exists; however, additional evidence may be needed for a determination. 1305.2 A suspension shall be put into effect only after the provisions in §1305 through §1308 have been complied with and the Director has determined that the suspension of payments in whole or in part, is needed to protect the program against financial loss. 1305.3 The suspension shall be used to recover or aid in the recovery of overpayments that have been made to the provider. SOURCE: Final Rulemaking published at 31 DCR 3870 (August 3, 1984).