House of Representatives State of Utah



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         P.O. BOX 145030 . SALT LAKE CITY, UTAH 84114-5030 . (801) 538-1029

        February 25, 2013

Madam Speaker:

    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

{   Medicaid

             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

  or 72 months if fraud is suspected       .


    Paul Ray
    Committee Chair

Voting: 8-0-1
7 HB0315.HC1.wpd 2/26/13 8:59 am markandrews/MDA CJD/MDA

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