63A-13-205. Placement of hold on claims for reimbursement -- Injunction.
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Effective 5/6/2026
63A-13-205. Placement of hold on claims for reimbursement -- Injunction.
(1)The inspector general or the inspector general's designee may, without prior notice, order a hold on the payment of a claim for reimbursement submitted by a claimant if there is reasonable cause to believe that the claim, or payment of the claim, constitutes fraud, waste, or abuse, or is otherwise inaccurate.
(2)The office shall, within seven days after the day on which a hold described in Subsection
(1)is ordered, notify the claimant that the hold has been placed.
(3)The inspector general or the inspector general's designee may not maintain a hold longer than is necessary to determine whether the claim, or payment of the claim, constitutes fraud, waste, or abuse, or is otherwise inaccurate.
(4)A claimant may, at any time during which a hold is in place, appeal the hold under Title 63G, Chapter 4, Administrative Procedures Act .
(5)If a claim is approved or denied before a hearing is held under Title 63G, Chapter 4, Administrative Procedures Act , the appeal shall be dismissed as moot.
(6)The inspector general may request that the attorney general's office seek an injunction to prevent a person from disposing of an asset that is potentially subject to recovery by the state to recover funds due to a person's fraud or abuse.
(7)The Department of Health and Human Services and the division shall fully comply with a hold ordered under this section.
Amended by Chapter 48 , 2026 General Session