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The term “fraud” has been legally defined as an intentional false representation of a truth or matter of fact whether by words or by conduct, by false or misleading allegations, or by concealment of that which should have been disclosed, for the purposes of including another in reliance upon it to part with some valuable thing or surrender a legal right. Fraud may be indicated in a client or caregiver/provider overpayment. It is the responsibility of the CCA staff to determine whether there is indication of fraud and to report these findings.
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