633 RECOUPMENT OF MEDICAL ASSISTANCE (MAM)

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Medical assistance that is incorrectly paid on behalf of an individual is subject to recoupment if the erroneous payment was due to the client:

. withholding information;

. failing to comply with eligibility requirements; or

. making any type of error that results in incorrectly paid benefits.

Refer erroneously paid medical assistance cases that are caused by the above circumstances to the Office of Special Investigations (OSI).

Refer erroneously paid medical assistance cases involving nursing homes or Medicaid provider fraud to the Attorney General's Office.

See PART 635, RECOUPMENT: LEGAL ACTION, for more information.