Utah Medicaid Audit Finds About Half Of $1 Billion In Nursing Facility Payments Retained As Administrative Fees

Approximately half of the nearly $1 billion in Medicaid supplemental payments made to Utah skilled nursing facilities (SNFs) between 2016 and 2024 did not reach facilities for resident care, according to an audit by the Office of the Utah State Auditor. About $450 million was used for direct care, while nearly $500 million was retained by affiliated entities as administrative fees. The findings relate to the state’s Medicaid SNF upper payment limit (UPL) program.

The audit found that the Utah Department of Health and Human Services did not exercise sufficient oversight over how administrative fees were distributed and that . . .