No. 30827: R414-4X.Policy Statement on Denial of Payment to Medicaid Provider When Client Fails to Keep Scheduled Appointment

DAR File No.: 30827
Filed: 12/12/2007, 02:13
Received by: NL

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:

Section 26-1-5 grants the Department of Health the power to adopt, amend, or rescind rules that shall have the force and effect of law. In addition, Subsection 26-18-3(4) requires the 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 Chapter IV, Subchapter C, Part 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:

No written or oral comments have been received 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:

This rule is necessary to ensure the proper utilization of services by Medicaid providers. It also reduces the possibility of incorrect billing practices that may constitute fraud. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Division 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 [e-mail]

Authorized by:

David N. Sundwall, Executive Director