DAR File No. 42318

Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-22

Administrative Sanction Procedures and Regulations

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 42318
Filed: 11/09/2017 04:44:44 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Subsection 26-18-3(6) requires the Department of Health (Department) to provide disciplinary measures and sanctions for Medicaid providers who fail to comply with the rules and procedures of the Medicaid program. Further, 42 CFR 455 requires the Department to investigate fraud, and if necessary, to impose sanctions against providers.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department did not receive any written or oral comments regarding this rule.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

The Department will continue this rule because it provides the Department and the Provider Sanction Committee discretionary authority to sanction providers for current and past misconduct, thereby promoting quality and integrity within the Medicaid program.

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [email protected]

Effective:

11/09/2017

Authorized by:

Joseph Miner, Executive Director