WAC 182-520-0005 Washington apple health fraud referrals and overpayments
WAC 182-520-0005 Washington apple health fraud referrals and overpayments.
Effective July 14, 2016.
- The agency or the agency's designee may refer a case to the office of fraud and accountability for a fraud investigation when it has reliable information that the person purposely misrepresented their circumstances in order to qualify for Washington apple health.
- When a fraud investigation reveals substantial evidence to support a finding of fraud, the case is referred for prosecution. The prosecuting attorney's office decides which cases will be prosecuted.
- When a referral results in a conviction, an overpayment amount for the cost of the apple health coverage is established.
- The person is responsible to pay the agency for the amount of overpayment established as a result of a fraud conviction.