§ 71-5-188. Actuarial Study of Tenncare
71-5-1308. Administration of part.
§ 71-5-2602. Record Keeping
Upon submitting a claim for, or upon receiving payment for, goods, services, items, facilities or accommodations under the TennCare program, a managed care organization, provider, vendor, subcontractor, or any other person or entity, shall maintain adequate records for a minimum of five (5) years after the date on which payment was received, if payment was […]
§ 71-5-2603. Fraud Reporting Requirements — Immunity From Liability
All managed care organizations, contractors, subcontractors, providers or any other person or entity shall advise the office of TennCare inspector general immediately when there is actual knowledge, not subject to a testimonial privilege, that an act of recipient, enrollee, or applicant fraud is being, or has been committed. The office of TennCare inspector general shall […]
§ 71-5-2604. Administrative Remedies — Recovery of Costs — Contested Cases — Rules and Regulations — Final Orders
Without regard to any other civil or criminal liability that might attach, by operation of this section or any other law, the office of inspector general shall have an administrative remedy against an enrollee, recipient, applicant, or person purporting to be an enrollee, recipient, or applicant, who improperly obtains medical assistance benefits or any assistance […]
§ 71-5-181. Tennessee Medicaid False Claims Act — Short Title
71-5-188. Actuarial study of TennCare. 71-5-1308. Administration of part.
§ 71-5-2517. Authority to Require Periodic Provision of Specific Data — Compliance — Format of Data — Charge for Supplying Data — Sufficient Dedicated Storage Space and Access to Software — Construction
The office of inspector general is authorized to require periodic provision of specific categories, types, or collations of data without the necessity of issuing a new request at the commencement of each period. Compliance with a request by the office of inspector general is not dependent on approval by the bureau of TennCare, and it […]
§ 71-5-2518. Rules and Regulations
The inspector general shall have authority to promulgate rules and regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as are necessary to implement §§ 71-5-2513 — 71-5-2521. The rules shall be promulgated as emergency rules. The inspector general is designated as the agency person to review initial orders and […]
§ 71-5-2519. Written Petition for Objection to Providing Access to Data — Enforcement of Obligations
A person or entity requested to provide access to data pursuant to §§ 71-5-2513 — 71-5-2521 may object to providing all or part of such access by filing a written petition with the inspector general within thirty (30) days of receipt of notice of the request to which objection is made. The petition shall be […]
§ 71-5-2520. Collections of Penalties, Fees and Costs
All funds collected as civil penalties, attorney’s fees, costs, or costs of investigation by the inspector general, pursuant to this part or part 26, shall be deposited by the state treasurer in a separate account exclusively for the use of that office to defray the expenses of continued operations involving recipient fraud and abuse, including, […]
§ 71-5-2521. Report
The office of inspector general shall include in its annual report information on the progress of its data mining efforts, including any difficulties encountered in obtaining access to data from either private or government entities, and suggestions for legislative or other solutions.