Section 2-906 – Duties
(a) In addition to the powers set forth elsewhere in this subtitle, the Collaborative may: (1) Adopt bylaws, rules, and policies; (2) Adopt regulations to carry out this subtitle; (3) Maintain an office at the place designated by the Collaborative; (4) Apply for and receive grants, contracts, or other public or private funding; (5) Issue and award contracts and grants; and […]
Section 2-610 – In General
(a) Any remedy provided under this subtitle is in addition to any other appropriate legal or equitable relief provided under any other applicable State or federal statute or regulation. (b) (1) The State shall make all reasonable efforts to coordinate any investigation of an alleged violation under this subtitle with any investigation conducted by the federal government involving […]
Section 2-611 – Annual Reports
(a) Beginning October 1, 2010, the Inspector General of the Department and the Director of the Medicaid Fraud Control Unit in the Office of the Attorney General shall report annually to the General Assembly, in accordance with § 2–1257 of the State Government Article, the following information for the previous fiscal year: (1) The number of civil […]
Section 2-701 – Definitions
(a) In this subtitle the following words have the meanings indicated. (b) “Claim” has the meaning stated in § 2–501 of this title. (c) “Extrapolation” means the process of estimating an unknown value by projecting, with a calculated precision or margin of error, the results of the review of a sample to the universe from which the sample […]
Section 2-702 – Use of Extrapolation During Audits to Recover Overpayments
(a) Subject to the requirements of this subtitle, the Inspector General, or a contractor or an agent acting on behalf of the Inspector General, may use extrapolation during an audit to recover an overpayment from a provider if: (1) The federal government has also conducted an audit of the program for overpayment; and (2) The monetary recovery amount […]
Section 2-703 – When Extrapolation Permitted
(a) On a finding of an overpayment to a provider, the Inspector General may not use extrapolation unless there is a determination of a sustained or high level of payment error, as defined by regulation. (b) When using extrapolation to determine an overpayment, the sample to be used may not include claims: (1) In which the alleged overpayment […]
Section 2-704 – Methodology; Audit Team
(a) The Inspector General or a contractor or an agent of the Inspector General that conducts an audit under this subtitle in which extrapolation may be used shall: (1) Perform the audit in accordance with a methodology used by the federal government or conducted in accordance with Generally Accepted Auditing Standards (GAAS) and the Statement on Accounting […]
Section 2-506 – Annual Report on Office Activities
** TAKES EFFECT JULY 1, 2022 PER CHAPTERS 325 AND 326 OF 2021 ** On or before December 1 each year, the Office shall submit a report to the Secretary, the Governor, and, in accordance with § 2–1257 of the State Government Article, the Senate Budget and Taxation Committee, the Senate Finance Committee, the House […]
Section 2-705 – Procedure
(a) Not less than 15 calendar days before commencement of an audit by the Inspector General under this subtitle, the Inspector General shall give to the provider written notice of the audit, including: (1) The statistically valid sampling methodology to be used; (2) The name, contact information, and credentials of each individual conducting the audit, including the individual […]
Section 2-601 – Definitions
(a) In this subtitle the following words have the meanings indicated. (b) (1) “Claim” means a request or demand, under a contract or otherwise, for money or other property, whether or not the State has title to the money or property, that is: (i) Presented through a State health plan or a State health program to an officer, employee, […]