2011 Utah Code
Title 63J Budgeting
Chapter 4a Office of Inspector General of Medicaid Services
Section 202 Duties and powers of inspector general and office.

63J-4a-202. Duties and powers of inspector general and office.
(1) The inspector general shall:
(a) administer, direct, and manage the office;
(b) inspect and monitor the following in relation to the state Medicaid program:
(i) the use and expenditure of federal and state funds;
(ii) the provision of health benefits and other services;
(iii) implementation of, and compliance with, state and federal requirements; and
(iv) records and recordkeeping procedures;
(c) receive reports of potential fraud, waste, or abuse in the state Medicaid program;
(d) investigate and identify potential or actual fraud, waste, or abuse in the state Medicaid program;
(e) consult with the Centers for Medicaid and Medicare Services and other states to determine and implement best practices for discovering and eliminating fraud, waste, and abuse of Medicaid funds;
(f) obtain, develop, and utilize computer algorithms to identify fraud, waste, or abuse in the state Medicaid program;
(g) work closely with the fraud unit to identify and recover improperly or fraudulently expended Medicaid funds;
(h) audit, inspect, and evaluate the functioning of the division to ensure that the state Medicaid program is managed in the most efficient and cost-effective manner possible;
(i) regularly advise the department and the division of an action that should be taken to ensure that the state Medicaid program is managed in the most efficient and cost-effective manner possible;
(j) refer potential criminal conduct, relating to Medicaid funds or the state Medicaid program, to the fraud unit;
(k) determine ways to:
(i) identify, prevent, and reduce fraud, waste, and abuse in the state Medicaid program; and
(ii) recoup costs, reduce costs, and avoid or minimize increased costs of the state Medicaid program;
(l) seek recovery of improperly paid Medicaid funds;
(m) track recovery of Medicaid funds by the state;
(n) in accordance with Section 63J-4a-501:
(i) report on the actions and findings of the inspector general; and
(ii) make recommendations to the Legislature and the governor;
(o) provide training to agencies and employees on identifying potential fraud, waste, or abuse of Medicaid funds; and
(p) develop and implement principles and standards for the fulfillment of the duties of the inspector general, based on principles and standards used by:
(i) the Federal Offices of Inspector General;
(ii) the Association of Inspectors General; and
(iii) the United States Government Accountability Office.
(2) The office may conduct a performance or financial audit of:
(a) a state executive branch entity or a local government entity, including an entity described in Subsection 63J-4a-301(3), that:

(i) manages or oversees a state Medicaid program; or
(ii) manages or oversees the use or expenditure of state or federal Medicaid funds; or
(b) Medicaid funds received by a person by a grant from, or under contract with, a state executive branch entity or a local government entity.
(3) The inspector general, or a designee of the inspector general within the office, may take a sworn statement or administer an oath.