New York Codes Rules Regulations (Last Updated: March 27,2024) |
TITLE 9. Executive Department |
Subtitle KK. Program for Elderly Pharmaceutical Insurance Coverage |
Part 9660. Fraud and Abuse |
Sec. 9660.1. Referral of suspected fraud and abuse
Latest version.
- Whenever, in the conduct of a review and verification into the eligibility of an applicant or the recertification of a participant, the evaluation of utilization review reports or participant profiles, there is evidence of program fraud or abuse by an applicant or participant, the contractor shall promptly refer the matter to the executive director for review.