108C-11. Cooperation with investigations and audits.
(a) Providers shall cooperate with all announced and unannounced site visits, audits, investigations, post-payment reviews, or other program integrity activities conducted by the Department. Providers who fail to grant prompt and reasonable access or who fail to timely provide specifically designated documentation to the Department may be terminated from the North Carolina Medicaid or North Carolina Health Choice programs.
(b) The Department shall make all attempts to examine documentation without interfering with the clinical activities of the provider while conducting activities on the provider's premises.
(c) Nothing in this Chapter shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (2011-399, s. 1.)
Structure North Carolina General Statutes
North Carolina General Statutes
Chapter 108C - Medicaid Provider Requirements
§ 108C-1 - (Effective until contingency met see note) Scope; applicability of this Chapter.
§ 108C-2 - (Effective until contingency met see note) Definitions.
§ 108C-2.1 - Provider application and revalidation fee.
§ 108C-3 - (Effective until contingency met see note) Medicaid and Health Choice provider screening.
§ 108C-5 - Payment suspension and audits utilizing extrapolation.
§ 108C-5.1 - Post-payment review and recovery audit contracts.
§ 108C-6 - Agents, clearinghouses, and alternate payees; registration required.
§ 108C-7 - Prepayment claims review.
§ 108C-8 - (Effective until contingency met see note) Threshold recovery amount.
§ 108C-9 - (Effective until contingency met see note) Provider enrollment criteria.
§ 108C-10 - Change of ownership and successor liability.
§ 108C-11 - Cooperation with investigations and audits.