- (1) If Medicaid audits a ground ambulance provider's records to determine the correct transports for the assessment and determines the provider failed to accurately report correct transports, Medicaid shall fine the provider 5% of the provider's annual calculated assessment. The fine is payable within 30 days of invoice.
(2)(a) If a ground ambulance provider fails to fully pay that provider's assessment on or before the due date, Medicaid shall fine the provider 5% of the provider's quarterly calculated assessment. The fine is payable within 30 days of invoice.
- (b) The department shall suspend Medicaid payments to a ground ambulance provider until the provider pays the assessment and fine due in full or until the provider and the department reach a negotiated settlement.
- (3) If a Medicaid-enrolled ground ambulance provider fails to submit reporting required in Rule R911-8, Medicaid may suspend payment until the provider submits the reporting.
KEY: Medicaid
Date of Last Change: May 8, 2025
Notice of Continuation: April 7, 2025
Authorizing and Implemented or Interpreted Law: 26B-1-213; 26B-3-108; 26B-3-801