Sanctioning Medicaid Providers

Utah law provides for disciplinary measures and sanctions for Medicaid providers that do not follow rules or procedures of the program. Reasons for a sanction may include submitting fraudulent claims, false information to receive a higher payment or prior authorization, failing to maintain records necessary to substantiate services, failing to disclose records, breaching terms of the provider agreement, inducing patients to receive services not medically necessary, giving or receiving rebates for referrals, substandard services, and other violations identified by rule. Read the sanction rule at https://goo.gl/TVVc3A and at https://goo.gl/urWdEq