Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-1 - Utah Medicaid Program
Section R414-1-31 - Withholding of Payments
Universal Citation: UT Admin Code R 414-1-31
Current through Bulletin 2024-06, March 15, 2024
(1) In addition to other remedies allowed by law and unless specified otherwise, the Department may withhold payments to a provider or contractor if:
(a) the provider or contractor fails to
provide the requested information within 30 calendar days from the date of a
written request for information;
(b) the provider or contractor has an
outstanding balance owing the Department for any reason; or
(c) the provider or contractor receives more
than $5,000,000 in reimbursement annually from the Department and fails to
comply with 42 U.S.C.
1396a(a)(68).
(2) The Department or the Office of the Inspector General of Medicaid Services may determine a provider or contractor to be noncompliant if the provider or contractor cannot submit, upon request:
(a) an attestation of compliance
with the Social Security Act,
42 U.S.C.
1396a(a)(68); and
(b) an attestation of compliance with the
False Claims Act, 31 U.S.C.
Sections 3729 through
3733.
(3) The Department shall provide written notice before withholding payments.
(4) When the Department rescinds withholding of payments to a provider or contractor, it will, without notice, resume payments according to the regular claims payment cycle.
Disclaimer: These regulations may not be the most recent version. Utah may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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