Utah Admin. Code R539-16-7 - Caregiver Compensation Review Process, Recovery of Funds, and Penalties
(1)
(a) Funds for supported living or attendant
care services provided through the caregiver compensation service delivery
method are public funds that are appropriated to, and approved by, the
division.
(b) Funds are for the
delivery of services for the person during the approved period and for the
purposes stipulated in the service code descriptions.
(c) Public funds are subject to applicable
federal, state, and local laws and regulations pertaining to the use of public
funds.
(2) The division
may require the person to use a contracted provider rather than the caregiver
compensation service delivery method if the SAS employer fails to meet a
requirement in:
(a) federal or state law or
rule;
(b) the SAS employee
agreement; or
(c) the SAS employer
agreement.
(3) The
support coordinator shall review any billing quarterly to ensure that, for each
service, no duplication of a service, fraud, or overlap of submitted timesheets
has occurred for SAS and provider-based caregiver compensation.
(4) The misuse of any funds provided for the
caregiver compensation service delivery method for a purpose other than those
in the service description may subject the caregiver and contracted provider,
if applicable, to administrative sanctions, criminal prosecution, and liability
for repayment of the misused funds.
(5) For any findings of duplication of
services, erroneous timesheet submissions, or exceeding the amount of service
authorized in the person's person-centered budget, the department:
(a) shall recover any associated fund;
and
(b) may make a referral to the
Utah Office of Inspector General and the Medicaid Fraud Control Unit if waste,
fraud, or abuse of funds is suspected.
Notes
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