Department Actions

When an instance of fraud, abuse, or other misconduct is identified, the Department will take action to correct the problem as provided in this rule. Such corrective action may include: denial of payment, recoupment, payment suspension, provider agreement suspension, termination of provider agreement, imposition of civil monetary penalties, exclusion, participant lock-in, referral for prosecution, or referral to state licensing boards. (3-17-22) 021. - 099. (RESERVED)