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M.S.A. §256B.064

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Sanctions; Monetary Recovery

The Commissioner of Human Services may terminate payment to any Medicaid or Medicare provider who has been deemed ineligible for payments under the Social Security Act.  The Commissioner may also impose sanctions on a vendor of medical care for the following:

  1. Fraud, theft or abuse in the provision of care to beneficiaries of medical assistance;
  2. Presenting false or duplicative claims for services that are not medically necessary;
  3. Making false statements of material fact to obtain greater compensation repeatedly;
  4. Suspension as a Medicare provider;
  5. Refusal to allow the state to inspect records;
  6. Failure to repay an overpayment;
  7. Any reason that would cause the vendor to be excluded from the Medicare program.

The sanctions that the Commissioner can impose include suspension or withholding of payments to the vendor, suspension or termination from participation, or referral to the appropriate state licensing board.  The Commissioner is also authorized to obtain monetary recovery from a vendor who has been improperly paid, whether it be unintentional or intentional. 

Related Laws:  MN ADC 9505.2215

Current as of June 2015