Ask a question on the site
Questions
Lawyers
Blogs
Legislation
Contacts
Become a lawyer
Login Registration
§ 20-77-1701. Legislative findings and intent - (a) The General Assembly finds that: (1) Healthcare providers who...
§ 20-77-1702. Definitions - As used in this subchapter: (1) “Abuse” means a pattern...
§ 20-77-1703. Recoupment - (a) (1) The Department of Human Services shall not use...
§ 20-77-1704. Provider administrative appeals allowed - (a) The General Assembly finds it necessary to: (1) Clarify...
§ 20-77-1705. Explanations for adverse decisions required - Each denial or other deficiency that the Department of Human...
§ 20-77-1706. Reimbursement at an alternate level instead of complete denial - (a) (1) (A) Subject to § 20-77-1707 for retrospective reviews,...
§ 20-77-1707. Prior authorizations — Retrospective reviews - If the Department of Human Services requires a provider to...
§ 20-77-1708. Medical necessity - (a) There is a presumption in favor of the medical...
§ 20-77-1709. Promulgation before enforcement - (a) The Department of Human Services may not use state...
§ 20-77-1710. Delivery of files - (a) If the Department of Human Services makes an adverse...
§ 20-77-1711. Copies of records to be supplied to department — Exception - (a) Except as provided in subsection (b) of this section,...
§ 20-77-1712. Notices - When the Department of Human Services sends letters or other...
§ 20-77-1713. Deadlines - (a) The Department of Human Services may not issue a...
§ 20-77-1714. Hospital claims - (a) When more than one (1) hospital provides services to...
§ 20-77-1715. Federal law - (a) If any provision of this subchapter is found to...
§ 20-77-1716. Promulgation of rules - The Department of Human Services may promulgate rules to implement...
§ 20-77-1717. Timelines for audits - (a) If a Medicaid provider audit by the federal Medicaid...
§ 20-77-1718. Termination — Appeals - (a) A Medicaid provider that is aggrieved by an adverse...