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Balance Billing of Medicaid Patients – Prohibited

Utah Medicaid providers are prohibited from billing patients. Medicaid providers must accept the payment from Medicaid as payment in full. Providers may not bill Medicaid patients for services that are covered under Medicaid or by a Managed Care Organization (MCO). There are strict exceptions to this policy. Prohibition on billing Medicaid patients policy is located in the Section I: General Information Provider Manual located online at: https://medicaid.utah.gov/utah-medicaid-official-publications.

If you or someone you know has been billed by a provider for a Medicaid covered service, please report that suspected violation of Medicaid policy to the Utah Office of Inspector General.

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