section .0600 – administrative sanctions and recoupment


10A NCAC 22F .0601       RECOUPMENT

(a)  The ­Division shall seek full restitution of improper payments, as defined by 42 C.F.R. 431.958, which is adopted and incorporated by reference with subsequent changes or amendments and available free of charge at, made to providers by the Medicaid Program. Recovery may be by lump sum payment, by a negotiated payment schedule, or by withholding from the provider's pending claims the total or a portion of the recoupment amount.

(b)  A provider may seek reconsideration review of a recoupment imposed by the division under Rule .0402 of this Subchapter.


History Note:        Authority G.S. 108A‑25(b); 108C-5(g); 42 C.F.R. Part 431, Subpart Q; 42 C.F.R. Part 455, Subpart F; 42 C.F.R. Part 456;

Eff. February 1, 1982;

Amended Eff. May 1, 1984;

Readopted Eff. July 1, 2018.