13-001.01 Fraud or Abuse

If there is reason to believe that a client has defrauded or abused the Medicaid program, the Department shall refer the case to the Special Investigation Unit (SIU) to conduct a full investigation of the claim. Once a case has been referred to SIU, no additional action shall be taken with regard to the prosecution of the suspected fraud, except in accordance with instructions or approval by SIU.