Haw. Code R. § 17-1705-45

Current through September, 2024

Section 17-1705-45 - Recoupment of overpayment to providers

(a) The department shall recoup overpayment to providers when overpayment occurred for reasons including, but not limited to one of the following:

(1) Ineligible provider;

(2) Noncovered service;

(3) Noncovered drug;

(4) No approved prior authorization when a service requires one;

(5) Incorrect payment allowance identified through post payment review by department staff; or

(6) Claim processing error.

(b) The responsibility of recoupment may be assigned to the fiscal agent with whom the department has a contract.

Haw. Code R. § 17-1705-45

[Eff 08/01/94] (Auth: HRS § 346-14) (Imp: HRS § 346-44)