Special Notice
This notice was published in the September 15, 2016, issue (Vol. 2016, No. 18) of the Utah State Bulletin.
Special Notice: Recovery Audit Contractor Reimbursement Method
In accordance with state law and to clarify methods of reimbursement, the Division of Medicaid and Health Financing (DMHF) will amend Section 4.5 of the Medicaid State Plan concerning the Medicaid Recovery Audit Contractor (RAC) Program.
DMHF will now reimburse recovery audit contractors on a flat-fee basis rather than a contingency basis for the work of identifying overpayments and underpayments in the Medicaid program.
Compared to the most recent three-year weighted average, DMHF does not anticipate any impact to total annual expenditures.
This State Plan Amendment (SPA 16-0027-UT) is pending approval from the Centers for Medicare and Medicaid Services, and if approved, becomes effective 10/01/2016.
A copy of these changes may be obtained from Craig Devashrayee (801-538-6641), or by writing the Technical Writing Unit, Utah Department of Health, P.O. Box 143102, Salt Lake City, UT 84114-3102. Comments are welcome at the same address. Copies are also available at local county health department offices.
Additional Information
The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2016/b20160915.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.
For questions regarding this notice, please contact Craig Devashrayee, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [email protected].