Common use of Reporting Potential Provider Clause in Contracts

Reporting Potential Provider. Related Fraud, Waste, and Xxxxx (A) Pursuant to Utah Code Xxx. §63A-12-101 et seq., if the Contractor or a Provider becomes aware of potential Provider-related Fraud, Waste, or Abuse, the Contractor or the Provider shall report the incident, in writing, to the Utah Office of Inspector General of Medicaid Services (“Utah OIG”) or MFCU in the Utah Attorney General’s Office. (B) If the Contractor or Provider reports an incident to the Utah OIG or MFCU, the Contractor or Provider shall electronically submit a copy of the report to the Department. (C) Reports of Fraud, Waste, or Abuse made by the Contractor or a Provider shall be made to the Utah OIG or MFCU and the Department within fifteen working days of detection of the incident of Provider-related Fraud, Waste, or Abuse. (D) The Contractor or Provider shall include in the report: (1) Name and identification number of the suspected individual; (2) Source of the complaint (if anonymous, indicate as such); (3) Type of Provider or type of staff position, if applicable; (4) Nature of complaint; (5) Approximate dollars involved, if applicable and (6) The legal and administrative disposition of the case, if any, including actions taken by law enforcement to whom the case has been referred. (E) In accordance with 42 CFR 455.17(a) the Contractor shall report to the Department on a quarterly basis the number of complaints of Fraud, Waste, and Abuse has warranted a preliminary investigation. The report shall be submitted to the Department no later than 30 days after each quarter.

Reporting Potential Provider. Related Fraud, Waste, and Xxxxx (A) Pursuant to Utah Code Xxx. §63A-12-101 63J-4a-101 et seq., if the Contractor or a Provider becomes aware of potential Provider-related Fraud, Waste, or Abuse, the Contractor or the Provider shall report the incident, in writing, to the Utah Office of Inspector General of Medicaid Services (“Utah OIG”) or MFCU in the Utah Attorney General’s Office. (B) If the Contractor or Provider reports an incident to the Utah OIG or MFCU, the Contractor or Provider shall electronically submit a copy of the report to the Department. (C) Reports of Fraud, Waste, or Abuse made by the Contractor or a Provider shall be made to the Utah OIG or MFCU and the Department within fifteen working days of detection of the incident of Provider-related Fraud, Waste, or Abuse. (D) The Contractor or Provider shall include in the report: (1) Name and identification number of the suspected individual; (2) Source of the complaint (if anonymous, indicate as such); (3) Type of Provider or type of staff position, if applicable; (4) Nature of complaint; (5) Approximate dollars involved, if applicable and (6) The legal and administrative disposition of the case, if any, including actions taken by law enforcement to whom the case has been referred. (E) In accordance with 42 CFR 455.17(a) the Contractor shall report to the Department on a quarterly basis the number of complaints of Fraud, Waste, and Abuse has warranted a preliminary investigation. The report shall be submitted to the Department no later than 30 days after each quarter.

Reporting Potential Provider. Related Fraud, Waste, and Xxxxx (A) Pursuant to Utah Code Xxx. §63A-1263A-13-101 et seq., if the Contractor or a Provider becomes aware of potential Provider-related Fraud, Waste, or Abuse, the Contractor or the Provider shall report the incident, in writing, to the Utah Office of Inspector General of Medicaid Services OIG (“Utah OIG”) xxx@xxxx.xxx), or MFCU (XXXXXxxxxxxxxx@xxxxxx.xxx) in the Utah Attorney General’s Office. (B) If the Contractor or Provider reports an incident to the Utah OIG or MFCU, the Contractor or Provider shall electronically submit a copy of the report to the Department. (C) Reports of Fraud, Waste, or Abuse made by the Contractor or a Provider shall be made to the Utah OIG or MFCU and the Department within fifteen working days of detection of the incident of Provider-related Fraud, Waste, or Abuse. (D) The Contractor or Provider shall include in the report: (1) Name and identification number of the suspected individual; (2) Source of the complaint (if anonymous, indicate as such); (3) Type of Provider or type of staff position, if applicable; (4) Nature of complaint; (5) Approximate dollars involved, if applicable and (6) The legal and administrative disposition of the case, if any, including actions taken by law enforcement to whom the case has been referred. (E) In accordance with 42 CFR 455.17(a) the The Contractor shall report submit to the Department on a quarterly basis basis, no later than 30 calendar days after each reporting period, a report that includes: (1) in accordance with 42 CFR 455.17(a), the number of complaints of Fraud, Waste, and Abuse has that warranted a preliminary investigation. ; (2) the Providers against which the Contractor has taken any adverse action for program integrity reasons; and (3) the names of Providers against which the Contractor has taken any adverse action for Fraud, Waste or Abuse, and a description of the adverse action taken. (F) The Contractor shall provide a quarterly report shall be submitted to of the Department no later than 30 days after each quarterProviders which the Contractor has taken any adverse action against for program integrity reasons.

Reporting Potential Provider. Related Fraud, Waste, and Xxxxx (A) Pursuant to Utah Code Xxx. §63A-1263A-13-101 et seq., if the Contractor or a Provider becomes aware of potential Provider-related Fraud, Waste, or Abuse, the Contractor or the Provider shall report the incident, in writing, to the Utah Office of Inspector General of Medicaid Services OIG (“Utah OIG”) xxx@xxxx.xxx), or MFCU (XXXXXxxxxxxxxx@xxxxxx.xxx) in the Utah Attorney General’s Office. (B) If the Contractor or Provider reports an incident to the Utah OIG or MFCU, the Contractor or Provider shall electronically submit a copy of the report to the Department. (C) Reports of Fraud, Waste, or Abuse made by the Contractor or a Provider shall be made to the Utah OIG or MFCU and the Department within fifteen working days of detection of the incident of Provider-related Fraud, Waste, or Abuse. (D) The Contractor or Provider shall include in the report: (1) Name and identification number of the suspected individual; (2) Source of the complaint (if anonymous, indicate as such); (3) Type of Provider or type of staff position, if applicable; (4) Nature of complaint; (5) Approximate dollars involved, if applicable and (6) The legal and administrative disposition of the case, if any, including actions taken by law enforcement to whom the case has been referred. (E) In accordance with 42 CFR 455.17(a) the The Contractor shall report submit to the Department on a quarterly basis basis, no later than 30 calendar days after each reporting period, a report that includes: (1) in accordance with 42 CFR 455.17(a), the number of complaints of Fraud, Waste, and Abuse has that warranted a preliminary investigation. The report shall be submitted to ; (2) the Department no later than 30 days after each quarterProviders against which the Contractor has taken any adverse action for program integrity reasons; and (3) the names of Providers against which the Contractor has taken any adverse action for Fraud, Waste or Abuse, and a description of the adverse action taken.

Reporting Potential Provider. Related Fraud, Waste, and Xxxxx (A) Pursuant to Utah Code Xxx. §63A-1263A-13-101 et seq., if the Contractor or a Provider becomes aware of potential Provider-related Fraud, Waste, or Abuse, the Contractor or the Provider shall report the incident, in writing, to the Utah Office of Inspector General of Medicaid Services OIG (“Utah OIG”) xxx@xxxx.xxx), or MFCU (XXXXXxxxxxxxxx@xxxxxx.xxx) in the Utah Attorney General’s Office. (B) If the Contractor or Provider reports an incident to the Utah OIG or MFCU, the Contractor or Provider shall electronically submit a copy of the report to the DepartmentDepartment (mc- xxx@xxxx.xxx). (C) Reports of Fraud, Waste, or Abuse made by the Contractor or a Provider shall be made to the Utah OIG or MFCU and the Department within fifteen working days of detection of the incident of Provider-related Fraud, Waste, or Abuse, subject to the exception for Waste in Utah Code Xxx. 63A-13-501(1)(b). (D) The Contractor or Provider shall include in the report: (1) Name name and identification number of the suspected individual; (2) Source source of the complaint (if anonymous, indicate as such); (3) Type type of Provider or type of staff position, if applicable; (4) Nature nature of complaint; (5) Approximate approximate dollars involved, if applicable applicable; and (6) The the legal and administrative disposition of the case, if any, including actions taken by law enforcement to whom the case has been referred. (E) In accordance with 42 CFR 455.17(a) the The Contractor shall report submit to the Department on a quarterly basis basis, no later than 30 calendar days after each reporting period, a report that includes: (1) in accordance with 42 CFR 455.17(a), the number of complaints of Fraud, Waste, and Abuse has that warranted a preliminary investigation. The report shall be submitted to ; and (2) the Department no later than 30 days after each quarterProviders against which the Contractor has taken any adverse action for program integrity reasons. (3) the names of Providers against which the Contractor has taken any adverse action for Fraud, Waste or Abuse, and a description of the adverse action taken.

Reporting Potential Provider. Related Fraud, Waste, and Xxxxx (A) Pursuant to Utah Code Xxx. §63A-1263A-13-101 et seq., if the Contractor or a Provider becomes aware of potential Provider-related Fraud, Waste, or Abuse, the Contractor or the Provider shall report the incident, in writing, to the Utah Office of Inspector General of Medicaid Services (“Utah OIG”) or and MFCU in the Utah Attorney General’s Office. (B) If the Contractor or Provider reports an incident to the Utah OIG or MFCU, the Contractor or Provider shall electronically submit a copy of the report to the Department. (C) Reports of Fraud, Waste, or Abuse made by the Contractor or a Provider shall be made to the Utah OIG or MFCU and the Department within fifteen working days of detection of the incident of Provider-related Fraud, Waste, or Abuse. (D) The Contractor or Provider shall include in the report: (1) Name and identification number of the suspected individual; (2) Source of the complaint (if anonymous, indicate as such); (3) Type of Provider or type of staff position, if applicable; (4) Nature of complaint; (5) Approximate dollars involved, if applicable and (6) The legal and administrative disposition of the case, if any, including actions taken by law enforcement to whom the case has been referred. (E) In accordance with 42 CFR 455.17(a) the Contractor shall report to the Department on a quarterly basis the number of complaints of Fraud, Waste, and Abuse has warranted a preliminary investigation. The report shall be submitted to the Department no later than 30 days after each quarter. (F) The Contractor shall provide a quarterly report of the Providers which the Contractor has taken any adverse action against for program integrity reasons.