392 Neb. Admin. Code, ch. 4, § 008

Current through September 17, 2024
Section 392-4-008 - PROVIDER OVERPAYMENTS

The Department will take measures to promptly correct overpayments.

008.01 WRITTEN NOTICE. Providers will receive a written notice when an overpayment occurs.
008.02APPEAL. If the provider disagrees with the Department's determination, the provider has 30 days from the date of mailing to appeal the overpayment. Depending on the nature of the overpayment, the provider enrollment may also be terminated.
008.03RECOUPMENT. If the provider does not appeal or appeals unsuccessfully, the overpayment will be recouped from future billings for the same or different children, or from another service at a rate of no less than 50 percent per billing.
008.03(A)HOLDING OF PAYMENTS. The Department has the right to hold any payments if an overpayment is suspected. Other actions as permitted by law may be taken to collect provider overpayments.
008.04WILLFUL OVER-BILLING. When the evidence establishes that a provider willfully over-billed the Department, the matter will be referred for a fraud investigation or will be referred to the appropriate agency or agencies for a fraud investigation. Any information, documentation, investigative reports, et cetera, that are developed or obtained will be shared with other programs within the Department and with appropriate state agencies.

392 Neb. Admin. Code, ch. 4, § 008

Adopted effective 9/15/2020