Regulation detail

22-A5305

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22-A5305 AUDITS

Jurisdiction: DC Agency: DC Department of Behavioral Health (DBH) — Title 22-A; and DC Department of Health Care Finance (DHCF) — Title 29 Medicaid behavioral-health chapters
CMHC (60%) OUTPATIENT (60%)
Plain-English summary

MHRS (Mental Health Rehabilitation Services) providers must cooperate with any Department-requested audit or investigation related to service claims, including providing all necessary documentation. Failure to cooperate may result in recoupment of reimbursements and other enforcement actions under applicable policies and the Health Care Agreement.

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Regulation text
5305 AUDITS

5305.1 An MHRS provider shall, upon the request of the Department, cooperate in any audit or investigation concerning claims for the provision of these services. Failure to cooperate or to provide the necessary information and documentation shall result in recoupment of the reimbursement and may result in other actions available to the Department pursuant to applicable policies and the HCA. 

SOURCE: Final Rulemaking published at 61 DCR 3787 (April 11, 2014).

District of Columbia Municipal Regulations

 Mental Health
22-A DCMR § 5305