Federal and State laws mandate identifying and recovering improper payments and other program integrity activities through audits, investigations and reviews. The following regulations, citations and/or memorandums listed below are for information purposes only; this is not an all-inclusive listing: 

 

Other Federal mandates and requirements:

Code of Federal Regulations 

42 CFR 431.10 State agency designee to administer Medicaid Program

42 CFR 447.202 Payment for services - Audits

42 CFR 455 Program Integrity: Medicaid

42 CFR 438 Managed Care

42 CFR 456 Utilization Control

42 CFR 1001 Program Integrity

 

Title: 29 Public Welfare  - Chapter: 29-13 Medicaid Program Administrative Procedures (http://dcregs.dc.gov/Gateway/ChapterHome.aspx?ChapterNumber=29-13)

 

Title: 29 Public Welfare  - Chapter: 29-19 HOME AND COMMUNITY-BASED SERVICES WAIVER FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTALDISABILITIES (http://dcregs.dc.gov/Gateway/ChapterHome.aspx?ChapterNumber=29-19)

 

Sec. 1902. [42 U.S.C. 1396a] - STATE PLANS FOR MEDICAL ASSISTANCE (https://www.gpo.gov/fdsys/search/pagedetails.action?granuleId=USCODE-2010-title42-chap7-subchapXIX-sec1396a&packageId=USCODE-2010-title42)