House of Representatives
State of Utah
February 25, 2013
The Health and Human Services Committee recommends H.B. 315, OFFICE OF INSPECTOR
GENERAL OF MEDICAID SERVICES AMENDMENTS, by Representative J. Dunnigan, be replaced
and reports a favorable recommendation on 1st Sub. H.B. 315, OFFICE OF INSPECTOR GENERAL
OF MEDICAID SERVICES AMENDMENTS with the following amendments:
1. Page 5, Lines 122 through 125 :
122 (b) If there is a conflict between the Medicaid state plan, administrative rules,
123 Medicaid provider manuals, or a Medicaid information bulletin issued by the department, a
124 health care provider may rely on the policy interpretation included in a current
125 provider manual or current } Medicaid information bulletin that is available to the public.
1. Page 5, Lines 129 through 134 :
129 63J-4a-204. Selection and review of claims.
130 (1) (a) On an annual basis, the office shall select and review a representative sample of
131 claims submitted for reimbursement under the state Medicaid program to determine whether
132 fraud, waste, or abuse occurred.
133 (b) The office shall limit its review for waste and abuse under Subsection (1)(a) to
134 months prior to the date of the inception of the investigation
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