The recovery of Medicaid related to unauthorized co-enrollment is waived during the transition period, except in the situation where multiple providers are operated by the same sponsor. What does the exception mean?
If, during the transition period, unauthorized co-enrollment occurs which involves providers operated by different sponsors, no recovery of the applicable Medicaid payments will be completed. However, if such co-enrollment involves programs which are operated by the same sponsor (i.e., both programs are controlled by the same entity) (see definition in Appendix 3 of T-1A), the applicable Medicaid payments will be recovered, even during the transition period.
Related Questions
- The recovery of Medicaid related to unauthorized co-enrollment is waived during the transition period, except in the situation where multiple providers are operated by the same sponsor. What does the exception mean?
- How long is the recovery period after the ReSTOR® IOL procedure?
- What is Medicaid asset recovery?
