OAR 333-010-0170: Denial or Recovery of Reimbursement Resulting from Review or Audit

(1) The Center’s staff, contractor or auditor may review a claim for assurance that the specific medical service was provided in accordance with the program’s policies and rules and the generally accepted standards of a provider’s scope of practice or specialty. (2) Payment may be denied or subject to recovery if review or audit determines the service does not meet the program’s policies, rules or the Standards of Care for Breast and Cervical Cancer Screening and Diagnostic Services set forth in OAR 333-010-0130.