26B-3-139.  Adjudicative proceedings related to Medicaid funds.

(1)  If a proceeding of the department, under Title 63G, Chapter 4, Administrative Procedures Act, relates in any way to recovery of Medicaid funds:

Terms Used In Utah Code 26B-3-139

  • Division: means the Division of Integrated Healthcare within the department, established under Section 26B-3-102. See Utah Code 26B-3-101
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Executive director: means the executive director of the department appointed under Section 26B-1-203. See Utah Code 26B-1-102
  • Medical assistance: means services furnished or payments made to or on behalf of a member. See Utah Code 26B-3-101
  • Person: means :Utah Code 68-3-12.5
  • Presiding officer: A majority-party Senator who presides over the Senate and is charged with maintaining order and decorum, recognizing Members to speak, and interpreting the Senate's rules, practices and precedents.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
(a)  the presiding officer shall be designated by the executive director of the department and report directly to the executive director or, in the discretion of the executive director, report directly to the director of the Office of Internal Audit; and

(b)  the decision of the presiding officer is the recommended decision to the executive director of the department or a designee of the executive director who is not in the division.

(2)  Subsection (1) does not apply to hearings conducted by the Department of Workforce Services relating to medical assistance eligibility determinations.

(3)  If a proceeding of the department, under Title 63G, Chapter 4, Administrative Procedures Act, relates in any way to Medicaid or Medicaid funds, the following may attend and present evidence or testimony at the proceeding:

(a)  the director of the Office of Internal Audit, or the director’s designee; and

(b)  the inspector general of Medicaid services or the inspector general’s designee.

(4)  In relation to a proceeding of the department under Title 63G, Chapter 4, Administrative Procedures Act, a person may not, outside of the actual proceeding, attempt to influence the decision of the presiding officer.

Renumbered and Amended by Chapter 306, 2023 General Session