Ch. 16, § 7. Claim Adjustments and Denials

(a) The Department shall make a claim adjustment after Medicaid payment has been made. If there is an adjusted amount, the Department may recover the adjustment amount. (b) The Department shall deny claims which are improperly submitted or which contain errors of any kind. Such claims may be resubmitted, subject to applicable federal and state requirements. (c) A provider may not request reconsideration or an administrative hearing regarding a claims adjustment/denial.