Audit says Utah losing millions to Medicaid fraud, waste

Hales said the health department has already began reorganizing for better cost-effectiveness and organizational efficiency, including requiring physicians to review all prior authorization cases.

House Speaker Clark, R-Santa Clara, and other committee members still expressed concern over the problems revealed in the report.

"The Medicaid program is meant to help people who need it most," he said. "This is the largest single entity that spends money in the state of Utah. I was most disappointed. This is the first audit I've seen that has six chapters of issues. I'm still not comfortable with their written and stated response."

Auditors showed how an updated analytical search system has worked for Healthy U, an infant-care program at the University Hospitals and Clinics, and could work for the Bureau of Program Integrity by comparing a provider's billing practice against normal billing practices, detecting payment errors and recovering accurate data — saving millions of dollars over time.

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