section .0600 administrative sanctions and recoupment



(a) The Medicaid Agency will seek full restitution of any and all improper payments made to providers by the Medicaid Program. Recovery may be by lump sum payment, by a negotiated payment schedule not to exceed one year or by withholding from the provider's pending claims the total or a portion of the recoupment amount.

(b) A provider may argue all or a part of a recoupment imposed by the Medicaid Agency by requesting a Reconsideration Review of the investigative findings and, thereafter, an Executive Decision.


History Note: Authority G.S. 108A‑25(b); 42 C.F.R. Part 431; 42 C.F.R. Part 455; 42 C.F.R. Part 456;

Eff. February 1, 1982;

Amended Eff. May 1, 1984.