Contract: A legal written agreement that becomes binding when signed.
Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
Youth transportation company: means any person that transports a child for payment to or from a congregate care program in Utah. See Utah Code 26B-2-101
(a)
A person who owns, establishes, conducts, maintains, manages, or operates a human services program in violation of this part is guilty of a class A misdemeanor if the violation endangers or harms the health, welfare, or safety of persons participating in that program.
(b)
Conviction in a criminal proceeding does not preclude the office from:
(i)
assessing a civil penalty or an administrative penalty;
(ii)
denying, placing conditions on, suspending, or revoking a license; or
(iii)
seeking injunctive or equitable relief.
(2)
Any person that violates a provision of this part, lawful orders of the office, or rules adopted under this part may be assessed a penalty not to exceed the sum of $10,000 per violation, in:
Assessment of a judicial penalty or an administrative penalty does not preclude the office from:
(a)
seeking criminal penalties;
(b)
denying, placing conditions on, suspending, or revoking a license; or
(c)
seeking injunctive or equitable relief.
(4)
The office may assess the human services program the cost incurred by the office in placing a monitor.
(5)
Notwithstanding Subsection (1)(a) and subject to Subsections (1)(b) and (2), an individual is guilty of a class A misdemeanor if the individual knowingly and willfully offers, pays, promises to pay, solicits, or receives any remuneration, including any commission, bonus, kickback, bribe, or rebate, directly or indirectly, overtly or covertly, in cash or in kind, or engages in any split-fee arrangement in return for:
(a)
referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for the treatment of a substance use disorder;
(b)
receiving a referred individual for the furnishing or arranging for the furnishing of any item or service for the treatment of a substance use disorder; or
(c)
referring a clinical sample to a person, including a laboratory, for testing that is used toward the furnishing of any item or service for the treatment of a substance use disorder.
(6)
Subsection (5) does not prohibit:
(a)
any discount, payment, waiver of payment, or payment practice not prohibited by 42 U.S.C. § 1320a-7(b) or regulations made under 42 U.S.C. § 1320a-7(b);
(b)
patient referrals within a practice group;
(c)
payments by a health insurer who reimburses, provides, offers to provide, or administers health, mental health, or substance use disorder goods or services under a health benefit plan;
(d)
payments to or by a health care provider, practice group, or substance use disorder treatment program that has contracted with a local mental health authority, a local substance abuse authority, a health insurer, a health care purchasing group, or the Medicare or Medicaid program to provide health, mental health, or substance use disorder services;
(e)
payments by a health care provider, practice group, or substance use disorder treatment program to a health, mental health, or substance use disorder information service that provides information upon request and without charge to consumers about providers of health care goods or services to enable consumers to select appropriate providers or facilities, if the information service:
(i)
does not attempt, through standard questions for solicitation of consumer criteria or through any other means, to steer or lead a consumer to select or consider selection of a particular health care provider, practice group, or substance use disorder treatment program;
(ii)
does not provide or represent that the information service provides diagnostic or counseling services or assessments of illness or injury and does not make any promises of cure or guarantees of treatment; and
(iii)
charges and collects fees from a health care provider, practice group, or substance use disorder treatment program participating in information services that:
(A)
are set in advance;
(B)
are consistent with the fair market value for those information services; and
(C)
are not based on the potential value of the goods or services that a health care provider, practice group, or substance use disorder treatment program may provide to a patient; or
(f)
payments by a laboratory to a person that:
(i)
does not have a financial interest in or with a facility or person who refers a clinical sample to the laboratory;
(ii)
is not related to an owner of a facility or a person who refers a clinical sample to the laboratory;
(iii)
is not related to and does not have a financial relationship with a health care provider who orders the laboratory to conduct a test that is used toward the furnishing of an item or service for the treatment of a substance use disorder;
(iv)
identifies, in advance of providing marketing or sales services, the types of clinical samples that each laboratory will receive, if the person provides marketing or sales services to more than one laboratory;
(v)
the person does not identify as or hold itself out to be a laboratory or part of a network with an insurance payor, if the person provides marketing or sales services under a contract with a laboratory, as described in Subsection (6)(f)(vii)(B);
(vi)
the person identifies itself in all marketing materials as a salesperson for a licensed laboratory and identifies each laboratory that the person represents, if the person provides marketing or sales services under a contract with a laboratory, as described in Subsection (6)(f)(vii)(B); and
(vii)
(A)
is a sales person employed by the laboratory to market or sell the laboratory’s services to a person who provides substance use disorder treatment; or
(B)
is a person under contract with the laboratory to market or sell the laboratory’s services to a person who provides substance use disorder treatment, if the total compensation paid by the laboratory does not exceed the total compensation that the laboratory pays to employees of the laboratory for similar marketing or sales services.
(7)
(a)
A person may not knowingly or willfully, in exchange for referring an individual to a youth transportation company:
(i)
offer, pay, promise to pay, solicit, or receive any remuneration directly or indirectly, overtly or covertly, in cash or in kind, including:
(A)
a commission;
(B)
a bonus;
(C)
a kickback;
(D)
a bribe; or
(E)
a rebate; or
(ii)
engage in any split-fee arrangement.
(b)
A person who violates Subsection (7)(a) is guilty of a class A misdemeanor and shall be assessed a penalty in accordance with Subsection (2).
Renumbered and Amended by Chapter 305, 2023 General Session
