All Roll Calls
Yes: 154 • No: 0
UtahS.B. 1472026 General SessionSenateWALLET
Office of Inspector General of Medicaid Services Amendments
Sponsored By: Luz Escamilla (Democratic)
Signed by Governor
Health InsuranceHealth and Human ServicesLegislative OperationsLegislative OrganizationDepartment of Government OperationsGovernment Operations (State Issues)MedicaidLegislative Staff Offices
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 1 benefits, 0 costs, 3 mixed.
Broader Medicaid record access with privacy
The inspector general can access state, local, and provider records tied to Medicaid. The office may check databases for identity, income, and jobs to verify eligibility and payments. When auditing providers, access should stay within the audit scope and occur during business hours, unless there is a credible fraud claim. The office must follow HIPAA and 42 C.F.R. Part 2. Data held by the Utah Health Data Authority stays under its own access law.
Stronger Medicaid audits with guardrails
The inspector general can put a hold on a Medicaid payment without prior notice when there is reasonable cause. The office must notify the claimant within seven days, keep the hold only as long as needed, and allow an appeal. Reviews for waste or abuse are limited to 36 months; to 72 months if there is a credible fraud allegation. Extrapolation is allowed only if all three are true: over a 10% error rate for a service code over three years, education failed, and over $200,000 a year was paid for that code; providers can appeal the sample or each claim. Audit contractors must be paid a flat fee, not a cut of recoveries.
Medicaid oversight reports and whistleblowers
The inspector general must publish an annual report by November 1 with audit results, dollars recovered, trends, and recommendations. The report goes to lawmakers and the governor and cannot jeopardize criminal cases. The executive director sets performance measures and reports results to committees and the advisory board. The office must take employee and public complaints, allow anonymous tips, respond, and ban retaliation against good‑faith reporters.
New Medicaid Inspector General office
Beginning May 6, 2026, the law creates a Medicaid Inspector General inside the Department of Government Operations. The governor appoints the inspector general for a four‑year term. The office audits and investigates Medicaid spending, trains agencies and providers, and can refer crimes and seek court orders to preserve assets for recovery. State health agencies, contractors, and providers must cooperate. The office may make rules for inspections and audits, but it cannot change Medicaid policy. The law defines abuse, fraud, and upcoding to guide enforcement.
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Sponsors & Cosponsors
Sponsor
Luz Escamilla
Democratic • Senate
Cosponsors
Norman K Thurston
Republican • House
Roll Call Votes
House vote • 3/6/2026
House/ substituted
Yes: 0 • No: 0
Senate vote • 3/6/2026
Senate/ concurs with House amendment
Yes: 28 • No: 0
House vote • 3/6/2026
House/ passed 3rd reading
Yes: 68 • No: 0
House vote • 3/6/2026
House/ floor amendment
Yes: 0 • No: 0
House vote • 2/19/2026
House Comm - Favorable Recommendation
Yes: 9 • No: 0
Senate vote • 2/17/2026
Senate/ substituted
Yes: 0 • No: 0
Senate vote • 2/17/2026
Senate/ passed 3rd reading
Yes: 24 • No: 0
Senate vote • 2/17/2026
Senate/ uncircled
Yes: 0 • No: 0
Senate vote • 1/23/2026
Senate/ circled
Yes: 0 • No: 0
Senate vote • 1/22/2026
Senate/ passed 2nd reading
Yes: 25 • No: 0
Senate vote • 1/22/2026
Senate/ substituted
Yes: 0 • No: 0
Actions Timeline
Governor Signed
3/17/2026Senate/ to Governor
3/13/2026SenateSenate/ received enrolled bill from Printing
3/13/2026SenateSenate/ enrolled bill to Printing
3/12/2026SenateEnrolled Bill Returned to House or Senate
3/12/2026Draft of Enrolled Bill Prepared
3/10/2026Bill Received from Senate for Enrolling
3/10/2026Senate/ signed by President/ sent for enrolling
3/6/2026SenateSenate/ received from House
3/6/2026SenateHouse/ to Senate
3/6/2026HouseHouse/ signed by Speaker/ returned to Senate
3/6/2026HouseHouse/ received from Senate
3/6/2026HouseSenate/ to House
3/6/2026SenateSenate/ concurs with House amendment
3/6/2026SenateSenate/ placed on Concurrence Calendar
3/6/2026SenateSenate/ received from House
3/6/2026SenateHouse/ to Senate
3/6/2026HouseHouse/ passed 3rd reading
3/6/2026HouseHouse/ floor amendment
3/6/2026HouseHouse/ substituted
3/6/2026HouseHouse/ 3rd reading
3/6/2026HouseHouse/ Rules to 3rd Reading Calendar
3/5/2026HouseHouse/ 3rd Reading Calendar to Rules
2/20/2026HouseHouse/ 2nd reading
2/20/2026HouseHouse/ committee report favorable
2/20/2026House
Bill Text
Enrolled
3/12/2026
Amended 3/6/2026 11:03:209
3/6/2026
Substitute #3
3/3/2026
Substitute #2
2/13/2026
Substitute #1
1/21/2026
Introduced
1/16/2026
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