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Program Integrity actively monitors the quality and reliability of Utah Medicaid providers, ensures fiscal integrity and compliance with State and Federal Rules and Regulations and develops, implements, and enforces measures to identify, prevent and reduce fraud, waste and abuse in the Medicaid System. The information provided in this website is intended to help Medicaid providers, recipients and the public better understand the purpose and functions of the Office of Inspector General/Program Integrity.
Utah Program Integrity is committed to identifying fraud, waste and abuse of the Medicaid Program. We pursue each referral of suspected fraud, waste and abuse we receive and use the information to open investigations. Program Integrity receives referrals from patients, their families, other providers, the public, and through various federal and state agencies.
Fraud & Abuse Referrals
Utah Program Integrity relies on referrals of suspected fraud, waste and abuse. Referrals of suspected provider fraud, waste & abuse can either be made by calling Program Integrity's Fraud Hotline at 855-403-7283 or by completing the online Provider Referral Form.
Identifying inappropriate payments made to Medicaid providers allows Program Integrity to recover the overpayments made with Medicaid funds. The money is then returned to Medicaid and used to provide much needed services to eligible Medicaid recipients.
Before making a referral, gather as much information as possible. Helpful information includes the name of the Medicaid provider, their office location, the name of the person receiving the service, their date of birth, and the date the service was received. If you are unable to obtain all of this information, provide what you have.
You can remain anonymous when reporting suspected fraud, waste & abuse of the Medicaid program.
OIG Mission Statement
We, the Office of the Inspector General, commit to safeguarding taxpayer assets through the minimization of fraud, waste, and abuse. We are committed to treating all key stakeholders fairly.