C.R.S. § 25.5-1-115.5: Medical assistance fraud - report.
Where this section sits in the code
- Title 25.5 - HEALTH CARE POLICY AND FINANCING
- Article 1 - Department of Health Care Policy and Financing
- Part 1 - GENERAL PROVISIONS
(1) Notwithstanding section 24-1-136 (11)(a)(I), on or before November 1, 2017, and each November 1 thereafter, the state department shall submit a written report to the joint budget committee; to the house of representatives judiciary committee and the house of representatives health and human services committee, or their successor committees; and to the senate judiciary committee and the senate health and human services committee, or their successor committees, concerning fraud in the medicaid program. The state department shall compile a single, comprehensive report that includes the information described in this subsection (1), as well as information that the attorney general provides to the state department pursuant to section 25.5-4-303.3. The state department shall report to the general assembly concerning the fraudulent receipt of medicaid benefits, including, at a minimum:
(a) Investigations of member fraud during the year;
(b) Termination of member medicaid benefits due to fraud;
(c) District attorney action, including, at a minimum, criminal complaints requested, cases dismissed, cases acquitted, convictions, and confessions of judgment;
(d) Recoveries, including fines and penalties, restitution ordered, and restitution collected;
(e) Trends in methods used to commit member fraud, excluding law enforcement-sensitive information; and
(f) An estimate of the total savings, total cost, and net cost-effectiveness of fraud detection and recovery efforts.
Collected 2026-09-14T18:37:45Z. Source file · JSON