Credible allegation of fraud means an allegation which has been verified by the department.
Credible allegation of fraud means an allegation for fraud, which has been verified by the Authority or delegate, from any source, including but not limited to: fraud hotline complaints, claims data mining, and patterns identified through provider audits, civil false claims cases, and law enforcement investigations. Allegations are considered to be credible when they have the indicia of reliability and the Agency has reviewed all allegations, facts and evidence carefully and acts judiciously on a case-by-case basis.¶
Credible allegation of fraud means an allegation of fraud, which has been verified by HCA, has indicia of reliability and HCA has reviewed all allegations, facts, and evidence carefully and acts judiciously on a case-by-case basis (42 C.F.R. § 455.2).
More Definitions of Credible allegation of fraud
Credible allegation of fraud means an allegation
Credible allegation of fraud means the Contractor has investigated an allegation of fraud and concluded that the existence of fraud is more probable than not. (42 C.F.R. § 455.2).
Credible allegation of fraud means an accusation of fraud as defined in section 5164.36 of the Revised Code.
Credible allegation of fraud means an allegation, which has been verified by the state, from any source, including but not limited to the following:
Credible allegation of fraud means an allegation of fraud that has been verified by the state. An allegation is considered to be credible when the commission has:
Credible allegation of fraud means an allegation for fraud, which has been verified by the Authority
Credible allegation of fraud means the Contractor has investigated an Allegation of Fraud and concluded that the existence of Fraud is more probable than not (42 C.F.R. § 455.2).