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§ 50781.5. Potential Overpayments--Unreported Other Health Coverage.

22 CA ADC § 50781.5Barclays Official California Code of Regulations

Barclays California Code of Regulations
Title 22. Social Security
Division 3. Health Care Services
Subdivision 1. California Medical Assistance Program (Refs & Annos)
Chapter 2. Determination of Medi-Cal Eligibility and Share of Cost
Article 16. Overpayments, Fraud and Improper Utilization
22 CCR § 50781.5
§ 50781.5. Potential Overpayments--Unreported Other Health Coverage.
Currentness
(a) A potential overpayment occurs when a beneficiary, or the person acting on the beneficiary's behalf, has knowingly failed to report other health coverage under either of the following circumstances:
(1) The other health coverage is of a type designated by the Department as not subject to post-service reimbursement, and the beneficiary who fails to utilize such other health coverage without good cause; or
(2) The beneficiary has received services for which Medi-Cal paid, and the beneficiary also claimed and received payment through private health care coverage.

Credits

Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Sections 14009, 14016.4 and 14024, Welfare and Institutions Code.
History
1. New section filed 4-13-93; operative 5-13-93 (Register 93, No. 16).
This database is current through 6/21/24 Register 2024, No. 25.
Cal. Admin. Code tit. 22, § 50781.5, 22 CA ADC § 50781.5
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