Title 63A, Title 63A: Utah Government Operations Code

63A-13-203. Memorandum of understanding with fraud unit. The inspector general shall enter into a memorandum of understanding with the fraud unit to: (1) formalize communication, cooperation, coordination of efforts, and the sharing of information, on a regular basis, between the…

63A-13-204. Selection and review of claims. (1) The office shall periodically select and review a representative sample of claims submitted for reimbursement under the Medicaid program to determine whether fraud, waste, or abuse occurred. The office shall limit the office's revie…

63A-13-205. Placement of hold on claims for reimbursement -- Injunction. (1) The inspector general or the inspector general's designee may, without prior notice, order a hold on the payment of a claim for reimbursement submitted by a claimant if there is reasonable cause to belie…

63A-13-301. Access to records -- Retention of designation under Government Records Access and Management Act. (1) In order to fulfill the duties described in Section, and in the manner provided in Subsection, the office shall have unrestricted access to all records of state execu…

63A-13-302. Access to employees -- Cooperating with investigation or audit. (1) The office shall have access to interview the following persons if the inspector general determines that the interview may assist the inspector general in fulfilling the duties described in Section: 6…

63A-13-303. Cooperation and support. The Department of Health and Human Services, the division, each consultant or contractor of the Department of Health and Human Services or division, and each provider shall provide its full cooperation and support to the inspector general and …

63A-13-304. Interference with an investigation or audit prohibited. No person may: (1) interfere with or impede an investigation or audit of the office or fraud unit; or (2) interfere with the office relative to the content of a report, the conclusions reached in a report, or the…

63A-13-305. Audit and investigation procedures. (1) The office shall, in accordance with Section, adopt administrative rules in consultation with providers and health care professionals subject to audit and investigation under this chapter to establish procedures for audits and i…

63A-13-401. Subpoena power -- Enforcement. (1) The inspector general has the power to issue a subpoena to obtain a record or interview a person that the office or inspector general has the right to access under. Part 3, Investigation or Audit (2) A person who fails to comply with…

63A-13-501. Duty to report potential Medicaid fraud to the office or fraud unit. (1) Except as provided in Subsection, a health care professional, a provider, or a state or local government official or employee who becomes aware of fraud, waste, or abuse shall report the fraud, w…

63A-13-502. Report and recommendations to governor and General Government Appropriations Subcommittee. (1) The inspector general of Medicaid services shall, on an annual basis, prepare an electronic report on the activities of the office for the preceding fiscal year. (2) The rep…

63A-13-601. Provision of contract services to Office of Inspector General of Medicaid Services. (1) The division and the assistant attorneys general assigned to the division shall provide, without charge, contract review, contract enforcement, and other contract management servic…

63A-13-602. Rulemaking authority. The office may make rules, in accordance with, and Section, that establish policies, procedures, and practices, in accordance with the provisions of this chapter, relating to: (1) inspecting and monitoring the Medicaid program; (2) discovering an…

63A-13-701. Office of Inspector General of Medicaid Services Advisory Board. (1) In consultation with the inspector general, the executive director or the executive director's designee shall create an advisory board known as the "Office of Inspector General of Medicaid Services A…