No. 35336 (5-year Review): Rule R414-320. Medicaid Health Insurance Flexibility and Accountability Demonstration Waiver

DAR File No.: 35336
Filed: 10/13/2011 12:00:58 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Section 26-18-3 requires the Department to implement Medicaid policy through administrative rules, which allow the Department to administer the Medicaid program. In addition, Section 26-1-5 grants the Department the authority to adopt administrative rules that provide services to Medicaid recipients and reimbursement for Medicaid providers. Section 1115 of the Social Security Act also allows the Department to implement demonstration waivers to verify whether they provide solutions on how to provide cost effective and beneficial services.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department did not receive any written or oral comments regarding this rule.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule is necessary because it outlines employer-sponsored coverage and eligibility requirements for enrollees of Utah's Premium Partnership for Health Insurance (UPP) program. It is also necessary because it outlines application requirements for enrollees, notice requirements for the Department, and reimbursement policy for employers. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [e-mail]

Authorized by:

David Patton, Executive Director

Effective:

10/13/2011

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