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COMAR 10.09.24.01-.16 1727 State of Maryland Medical Assistance Manual Revised July 2012

of final appeal rights, whichever is later, and

(ii) Does not extend to possession of blank Medical Assistance prescriptions which have been obtained from a source not authorized to distribute blank Medical Assistance prescriptions under §S(6)(a) of this regulation;

(c) Performance of one's lawful duties as a law enforcement officer or as one employed by a state Medical Assistance program; or

(d) The Director, Medical Care Compliance Administration;

(7) Possession of a Medical Assistance card or Pharmacy Assistance card without the authorization of the person to whom the card is issued, unless:

(a) Possession is obtained by a provider without knowledge that the presenting party lacked authorization;

(b) Possession is pursuant to one's lawful duties as a law enforcement officer or as one employed by a state Medical Assistance program; or

(c) Authorized by the Director, Medical Care Compliance Administration;

(8) Manufacture, distribution, or possession of a counterfeit Medical Assistance card, prescription blank, or Pharmacy Assistance card except when possession is obtained:

(a) By a provider without knowledge that the card or prescription blank is counterfeit; or

(b) Pursuant to one's lawful duties as a law enforcement officer or as one employed by a state Medical Assistance program; and

(9) Manufacture, distribution, or possession of a provider identification plate used or capable of use to imprint Medical Assistance prescriptions unless authorized by:

(a) A contract or other power, right, or permission to manufacture, transport, distribute, handle, or possess the plates;

(b) Issuance by a state Medical Assistance program to the party in possession;

(c) Performance of one's lawful duties as a law enforcement officer or as one employed by a state Medical Assistance program; or

(d) The Director, Medical Care Compliance Administration.

B. Examples. The following are examples of circumstances that may be Medicaid fraud:

(1) Failure to report income, resources, and family composition at the time of application or reapplication;

(2) Failure to report within 10 working days any changes in income, resources, and circumstances