StacksVerified U.S. regulatory reference

42 CFR §455.13

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
The Medicaid agency must have—
  1. (a)Methods and criteria for identifying suspected fraud cases;
  2. (b)Methods for investigating these cases that—
    1. (1)Do not infringe on the legal rights of persons involved; and
    2. (2)Afford due process of law; and
  3. (c)Procedures, developed in cooperation with State legal authorities, for referring suspected fraud cases to law enforcement officials.