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The Health Care Authority (HCA) strives to work together with our providers and provide education about program integrity. Federal and state laws mandate identifying and recovering improper payments and other program integrity activities through audits, investigations, and reviews.
Hospital Customer Satisfaction Inspection Survey: RCW 70.41.045(3) requires HCA, in collaboration with the Department of Health (DOH), to post on its website, a survey which allows a hospital to anonymously evaluate any audit process in terms of quality, efficacy, and the extent to which it supported improved patient care and compliance with state law without placing an unnecessary burden on the hospital. The survey supported by the DOH and completed surveys are sent to DOH.
On this page
Federal and state regulations
- Federal Executive Order No. 13520 (11/20/09)
- Improper Payments Information Act of 2002
- Presidential Memorandum Regarding Finding and Recapturing Improper Payments (3/10/2010)
Code of Federal regulations
- 42 CFR 456 Utilization Control
- 42 CFR 1001 Program Integrity - Medicare and State Health Care Programs
Revised Code of Washington (RCW)
- RCW 34.05 Administrative Procedure Act
- RCW 41.05A.170 Overpayment to vendor
- RCW 41.05A.220 Interest on overpayments to vendors
- RCW 74.09.195 Audits of health care providers by the authority—Requirements—Procedure
- RCW 74.09.200 Audits and investigations - Legislative declaration - State authority
- RCW 74.09.220 Liability for receipt of excess payments
- RCW 74.09.290 Audits and investigations of providers-Patient records-Penalties
Washington Administrative Code (WAC)
- WAC 182-501-0050 Health care general coverage
- WAC 182-502-0010 When the Medicaid agency enrolls
- WAC 182-502-0020 Health care record requirements
- WAC 182-502-0100 General conditions of payment
- WAC 182-502-0230 Provider overpayment disputes - General
- WAC 182-502A Program Integrity
- 2019 Program integrity educational webinar
For more information about program integrity, please visit our frequently asked questions (FAQs) document.