Common use of Medicaid Fraud Control Clause in Contracts

Medicaid Fraud Control. Unit (MFCU) means the statutorily authorized criminal investigation unit in the Utah Attorney General’s Office charged with investigating and prosecuting Medicaid Fraud. Medicaid Information Bulletin (MIB) means the official, periodic publication of the Division of Integrated Healthcare to update the Utah Medicaid Provider Manual or issue information to Medicaid Providers. Medical Loss Ratio (MLR) means the calculation the Contractor is required to quantify and report to the Department pursuant to 42 CFR § 438.8. Medically Necessary or Medical Necessity means medically necessary service as defined by Utah Administrative Code R414-1-2.