program-integrity-fraud-investigation-payment-recovery-and-sanctions SANCTIONS

Reason(s) for non-compliance: • The Lead Agency does not have a process to identify program violations by providers, investigate and recover fraudulent payments from providers, or impose sanctions on providers in response to fraud, as required by 98.68(b)(1). (Plan Questions 10.2.1, 10.2.2b, and 10.2.2e) Overall Target Completion Date: 03/31/2027 Action Step Number Action Step Description Target Completion Date 1 Technical assistance on process to identify program violations by providers, investigate and recover fraudulent payments from providers, or impose sanctions on providers in response to fraud. 12/30/2025 2 Draft Hawaii Administrative Rule to have a process to identify program violations by providers, investigate and recover fraudulent payments from providers, or impose sanctions on providers in response to fraud. 06/30/2026 3 Rule amendment routing process for adoption. 12/30/2026 4 Policy implemented. 03/31/2027