Section 2-501 – Definitions

    (a)    In this subtitle the following words have the meanings indicated.     (b)    “Abuse” means provider practices that are inconsistent with sound fiscal, business, or medical practices and result in unnecessary costs to a program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized health care standards.     (c)    “Claim” means a […]

Section 2-502 – Office of Inspector General Established

    (a)    There is a Maryland Office of the Inspector General for Health.     (b)    The Office is an independent unit of the State.     (c)    (1)    Subject to paragraph (2) of this subsection, the Office shall have access to the following services of the Department:             (i)    Information technology;             (ii)    Budget and finance;             (iii)    Human resources;             (iv)    Police;             (v)    Procurement; and             (vi)    Support services.         (2)    The Office shall, in […]

Section 2-502.1 – Inspector General in Office of the Inspector General for Health — Appointment of Individual — Restrictions on Outside Political Office — Qualifications — Removal

    ** TAKES EFFECT JULY 1, 2022 PER CHAPTERS 325 AND 326 OF 2021 **     (a)    There is an Inspector General in the Maryland Office of the Inspector General for Health.     (b)    (1)    An individual is eligible to be the Inspector General only if the individual executes an affidavit stating that the individual will not accept appointment to, or […]

Section 2-503 – Duties of Inspector General

    (a)    The Inspector General:         (1)    May investigate fraud, waste, and abuse of departmental funds;         (2)    Shall cooperate with and coordinate investigative efforts with the Medicaid Fraud Control Unit and where a preliminary investigation establishes a sufficient basis to warrant referral, shall refer such matters to the Medicaid Fraud Control Unit; and         (3)    Shall cooperate with and coordinate investigative efforts […]

Section 2-504 – Additional Duties

    The Inspector General, in collaboration with the appropriate departmental program, may:         (1)    Take necessary steps to recover any mistaken claims paid or payments obtained in error or fraudulent claims paid to or obtained by a provider; and         (2)    Take necessary steps to recover the cost of benefits mistakenly paid or obtained in error, or fraudulently paid to […]

Section 2-504.1 – Civil Money Remedies

    (a)    Except as otherwise prohibited by State or federal law, in the sole discretion of the Inspector General, the Inspector General may impose a civil money remedy against a provider for a violation of State or federal law governing the conditions of payment for any service or item for which the provider submitted a claim for […]

Section 2-505 – Civil Liability

    (a)    A person is not civilly liable for:         (1)    Making a report in good faith of fraud, waste, or abuse; or         (2)    Participating in any investigation related to fraud, waste, or abuse.     (b)    (1)    This subsection does not apply to an employee as defined in § 1-501(c) of the Health Occupations Article or a State employee.         (2)    A provider may not […]

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 […]