Medicaid; Revisions to State Medicaid Fraud Control Unit Rules
medicaid · Centers for Medicare and Medicaid Services · Rule · Published 2019-03-22 · Effective 2019-05-21 · 84 FR 10700
Document
Document number
2019-05362
Federal Register citation
84 FR 10700
CFR reference
42 CFR 455
Type
Rule
Action
Final rule.
Category
medicaid
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2019-03-22
Effective date
2019-05-21
Abstract
This final rule amends the regulation governing State Medicaid Fraud Control Units (MFCUs or Units). The rule incorporates statutory changes affecting the Units as well as policy and practice changes that have occurred since the regulation was initially issued in 1978. These changes include a recognition of OIG's delegated authority; Unit authority, functions, and responsibilities; disallowances; and issues related to organization, prosecutorial authority, staffing, recertification, and the Units' relationship with Medicaid agencies. The rule is designed to assist the MFCUs in understanding their authorities and responsibilities under the grant program, clarify the flexibilities the MFCUs have to operate their programs, and reduce administrative burden, where appropriate, by eliminating duplicative and unnecessary reporting requirements.