Section 11 – Presumption based on paid state warrant — Value of medical benefits — Repayment of benefits.
26-20-11. Presumption based on paid state warrant — Value of medical benefits — Repayment of benefits. (1) In any civil or criminal action brought under this chapter, a paid state warrant, made payable to the order of a party, creates a presumption that the party received funds from the state. (2) In any civil or […]
Section 12 – Violation of other laws.
26-20-12. Violation of other laws. (1) The provisions of this chapter are: (a) not exclusive, and the remedies provided for in this chapter are in addition to any other remedies provided for under: (i) any other applicable law; or (ii) common law; and (b) to be liberally construed and applied to: (i) effectuate the chapter’s […]
Section 13 – Medicaid fraud enforcement.
26-20-13. Medicaid fraud enforcement. (1) This chapter shall be enforced in accordance with this section. (2) The department is responsible for: (a) (i) investigating and prosecuting suspected civil violations of this chapter; or (ii) referring suspected civil violations of this chapter to the attorney general for investigation and prosecution; and (b) promptly referring suspected criminal […]
Section 14 – Investigations — Civil investigative demands.
26-20-14. Investigations — Civil investigative demands. (1) The attorney general may take investigative action under Subsection (2) if the attorney general has reason to believe that: (a) a person has information or custody or control of documentary material relevant to the subject matter of an investigation of an alleged violation of this chapter; (b) a […]
Section 15 – Limitation of actions — Civil acts antedating this section — Civil burden of proof — Estoppel — Joint civil liability — Venue.
26-20-15. Limitation of actions — Civil acts antedating this section — Civil burden of proof — Estoppel — Joint civil liability — Venue. (1) An action under this chapter may not be brought after the later of: (a) six years after the date on which the violation was committed; or (b) three years after the […]
Section 9 – Criminal penalties.
26-20-9. Criminal penalties. (1) (a) Except as provided in Subsection (1)(b) the culpable mental state required for a criminal violation of this chapter is knowingly, intentionally, or recklessly as defined in Section 76-2-103. (b) The culpable mental state required for a criminal violation of this chapter for kickbacks and bribes under Section 26-20-4 is knowingly […]
Section 9.5 – Civil penalties.
26-20-9.5. Civil penalties. (1) The culpable mental state required for a civil violation of this chapter is “knowing” or “knowingly” which: (a) means that person, with respect to information: (i) has actual knowledge of the information; (ii) acts in deliberate ignorance of the truth or falsity of the information; or (iii) acts in reckless disregard […]
Section 10 – Revocation of license of assisted living facility — Appointment of receiver.
26-20-10. Revocation of license of assisted living facility — Appointment of receiver. (1) If the license of an assisted living facility is revoked for violation of this chapter, the county attorney may file a petition with the district court for the county in which the facility is located for the appointment of a receiver. (2) […]
Section 3 – False statement or representation relating to medical benefits.
26-20-3. False statement or representation relating to medical benefits. (1) A person may not make or cause to be made a false statement or false representation of a material fact in an application for medical benefits. (2) A person may not make or cause to be made a false statement or false representation of a […]
Section 4 – Kickbacks or bribes prohibited.
26-20-4. Kickbacks or bribes prohibited. (1) For purposes of this section, kickback or bribe: (a) includes rebates, compensation, or any other form of remuneration which is: (i) direct or indirect; (ii) overt or covert; or (iii) in cash or in kind; and (b) does not include a rebate paid to the state under 42 U.S.C. […]