The provider's name is placed on the mailing list for Medicaid Information Bulletins. The provider agrees to comply with all laws, rules, and regulations governing the Medicaid Program. The Division may terminate any provider from further participation in Medicaid if the provider fails to satisfy all applicable criteria for eligibility. 6 - 3 Title XIX of the Social Security Act While enrolled as a Medicaid Provider, a provider must comply with the provisions of Title XIX of the Social Security Act and all applicable State and Federal regulations and standards listed in this chapter . The State is responsible for monitoring all medical assistance programs, including Medicaid, with respect to medical need, extent and appropriateness of care, and program effectiveness.
Monitoring includes audit procedures, onsite reviews, quality assurance and utilization reviews.
When providing medical assistance under programs administered by the Utah State Department of Health, a provider must agree to provide services in accordance with Title VI of the Civil Rights Act as well as other federal provisions which prohibit discrimination against any employee or applicant for employment based upon race, age, color, sex, creed, national origin or disability. Restrictions to individual patient care, based upon the limits placed upon provider practice by specialty, and because of medically related determinations made within the scope of practice, do not constitute violation of the Civil Rights Act provisions. Including Medicare A liable third party is any person or entity such as health insurance, a health maintenance organization, or Medicare, which may be responsible for services rendered to a Medicaid patient. This information is available from Medicaid and is printed on the Medicaid Identification Card. Refer to Chapter 5 - 4, Third Party Liability .