PUBLIC SAFETY AND WELFARE
PUBLIC ASSISTANCE TO BLIND, AGED, OR DISABLED PERSONS, AND TO DEPENDENT CHILDREN
Medicaid Fraud and False Claims
In this subdivision:
I. "Abuse" means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the medicaid program, or in reimbursement for services that are above those actually rendered, that are not medically necessary, or that fail to meet professionally recognized standards for health care.
I-a. "Commissioner" means the commissioner of the department of health and human services.
II. "Data" means information of any kind in any form, including computer software as defined in RSA 638:16, VI.
III. "Department" means the department of health and human services.
IV. "Fraud" means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under New Hampshire criminal code, RSA title LXII.
V. "Provider" means any individual, partnership, corporation or entity furnishing services under a written contract with the department.
VI. "Suspension" means the removal of a provider from participation in the medicaid program for not less than 60 days nor more than 6 months.
VII. "Termination" means the removal of a provider from participation in the medicaid program for an indefinite period of time.
Source. 1981, 189:2. 1983, 291:1. 1990, 260:1. 1995, 310:121, 175, eff. Nov. 1, 1995.