---
kind: "section"
citation: "42 C.F.R. § 455.16"
title: "42"
number: "455.16"
heading: "Resolution of full investigation."
url: "https://uscodex.org/cfr/42/455.16"
---

# §455.16. Resolution of full investigation.


A full investigation must continue until—

- (a) Appropriate legal action is initiated;
- (b) The case is closed or dropped because of insufficient evidence to support the allegations of fraud or abuse; or
- (c) **The matter is resolved between the agency and the provider or beneficiary.** This resolution may include but is not limited to—
  - (1) Sending a warning letter to the provider or beneficiary, giving notice that continuation of the activity in question will result in further action;
  - (2) Suspending or terminating the provider from participation in the Medicaid program;
  - (3) Seeking recovery of payments made to the provider; or
  - (4) **Imposing other sanctions provided under the State plan.**

## Notes

### Amendments

[43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3756, Jan. 27, 1983]

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45262, Sept. 29, 1978, unless otherwise noted.

### Amendments

[43 FR 45262, Sept. 29, 1978, as amended at 48 FR 3756, Jan. 27, 1983]