Page 15

UNOFFICIAL 1705-15

§17-1705-44 REPEALED. [R 09/30/13]

§17-1705-45 Recoupment of overpayment to providers. (a) The department shall recoup overpayment to providers when overpayment occurred for reasons including, but not limited to one of the following: (1) Ineligible provider; (2) Noncovered service; (3) Noncovered drug; (4) No approved prior authorization when a service requires one; (5) Incorrect payment allowance identified through post payment review by department staff; or (6) Claim processing error. (b) The responsibility of recoupment may be assigned to the fiscal agent with whom the department has a contract. [Eff 08/01/94 ] (Auth: HRS §346-14) (Imp: HRS §346-44)

§§17-1705-46 to 17-1705-50 (Reserved).

SUBCHAPTER 7

RECIPIENT RECOVERY

§17-1705-51 REPEALED. [R 09/30/13]

§17-1705-52 Recovery of medical care payments from recipients. (a) Payments made to medical care providers and payments made to health plans shall be recovered by the department from individuals who: (1) Provided erroneous information in qualifying for medical assistance; (2) Failed to report a change in circumstances which would have rendered the individual or household ineligible for continued medical assistance; (3) Failed to notify the department that a family member is no longer a member of the assistance household;

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Page 15

Official source

UNOFFICIAL 1705-15

§17-1705-44 REPEALED. [R 09/30/13]

§17-1705-45 Recoupment of overpayment to providers. (a) The department shall recoup overpayment to providers when overpayment occurred for reasons including, but not limited to one of the following: (1) Ineligible provider; (2) Noncovered service; (3) Noncovered drug; (4) No approved prior authorization when a service requires one; (5) Incorrect payment allowance identified through post payment review by department staff; or (6) Claim processing error. (b) The responsibility of recoupment may be assigned to the fiscal agent with whom the department has a contract. [Eff 08/01/94 ] (Auth: HRS §346-14) (Imp: HRS §346-44)

§§17-1705-46 to 17-1705-50 (Reserved).

SUBCHAPTER 7

RECIPIENT RECOVERY

§17-1705-51 REPEALED. [R 09/30/13]

§17-1705-52 Recovery of medical care payments from recipients. (a) Payments made to medical care providers and payments made to health plans shall be recovered by the department from individuals who: (1) Provided erroneous information in qualifying for medical assistance; (2) Failed to report a change in circumstances which would have rendered the individual or household ineligible for continued medical assistance; (3) Failed to notify the department that a family member is no longer a member of the assistance household;