Identifying improper payments -- Repayment -- Prevention.

Utah Code § 26B-3-1203, under Part 26B-3-12: Managed Care Transparency.

Utah Code § 26B-3-1203

26B-3-1203. Identifying improper payments -- Repayment -- Prevention.

(1) Each risk contractor and subcontractor shall quarterly: identify and document all improper payments; conduct a root cause analysis for each type of improper payment; repay all improper payments that are due to the Medicaid program no later than 30 days after the day on which the report described in Subsectionis due; and (2) develop and implement a corrective action plan that includes improvements in policies, procedures, accounting, financial management, internal controls, information systems, reporting, staffing, or training necessary to address improper payments.

(2) Each risk contractor and subcontractor shall quarterly submit to the division a report of the risk contractor's or subcontractor's improper payments, root cause analyses, and corrective action plan. The department shall publish the reports described in Subsectionon the department's website, unless posting a report would interfere with an ongoing investigation of the: (2)(a) Office of Inspector General of Medicaid Services created in Section; or 63A-13-301 Utah Medicaid Fraud Control Unit of the attorney general's office.

(3) The department shall make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to establish: due dates for the submission of reports described in Subsection; and (2) sanctions for a risk contractor's or subcontractor's failure to repay as described in Subsection, consistent with Section. (1)(c) 26B-3-108