Minnesota Administrative Rules

9505.0465 RECOVERY OF PAYMENT TO PROVIDER.

Subpart 1.

Department obligations to recover payment.

The department shall recover medical assistance funds paid to a provider if the department determines that the payment was obtained fraudulently or erroneously. Monetary recovery under the medical assistance program is permitted for the following:

A.

intentional and unintentional error on the part of the provider or state or local welfare agency;

B.

failure of the provider to comply fully with all authorization control requirements, prior authorization procedures, or billing procedures;

C.

failure to properly report third-party payments; and

D.

fraudulent or abusive actions on the part of the provider.

Subp. 2.

Methods of monetary recovery.

The monetary recovery may be made by withholding current payments due the provider, by demanding that the provider refund amounts so received as provided in part 9505.1950, or by any other legally authorized means.

Subp. 3.

Interest charges on monetary recovery.

If the department allows the provider to repay medical assistance funds by installment payments, the provider must pay interest on the funds to be recovered. The interest rate shall be the rate established by the Department of Revenue under Minnesota Statutes, section 270C.40.

Statutory Authority:

MS s 256B.04

History:

12 SR 624; L 2005 c 151 art 1 s 116

Published Electronically:

August 12, 2008