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UNOFFICIAL 1704-2 §17-1704-2 REPEALED. [R 09/30/13]
SUBCHAPTER 2
RECIPIENT FRAUD
§17-1704-3 Investigation of suspected fraud. (a) The department shall identify situations in which there are questions of suspected fraud such as, but not limited to, a recipient receiving medical assistance to which the individual is not entitled through willful misrepresentation of circumstances or the intentional concealment of information from the department.
(b)The DHS investigations office shall investigate…#
(b) The DHS investigations office shall investigate suspected fraud and refer these cases to law enforcement officials.
(c)The methods of investigation shall not infringe on the…#
(c) The methods of investigation shall not infringe on the legal rights of the persons involved and shall afford these individuals due process of law. [Eff 08/01/94 ] (Auth: HRS §346-14; 42 C.F.R. §431.10) (Imp: 42 C.F.R. §§455.13, 455.14, 455.15, 455.16)
§17-1704-4 Penalty. The department may initiate referral for prosecution of an individual suspected of fraud. In addition, the individual may be subject to any other criminal, civil, or administrative sanction authorized by law. [Eff 08/01/94 ] (Auth: HRS §346.14; 42 C.F.R. §431.10) Imp: 42 C.F.R. §§455.15, 455.16)
SUBCHAPTER 3
PROVIDER FRAUD
§17-1704-5 Preliminary investigation. (a) DHS shall conduct a preliminary investigation of all medicaid fraud complaints from whatever sources received to determine whether there is sufficient basis to warrant a full investigation.
(b) If the findings of the preliminary investigation indicate there is potential for criminal