Prior Auth Required

12650 - False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceFalse Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal
Procedure / Service Description

Laws and Regulations - Laws and Regulations False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § 12650-12656): The California and Federal False Claim Acts (FCAs) make it illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent. Filing false claims may result in fines of up to three times the program's

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.