No. 29148 (Amendment): R414-61-2. Incorporation by Reference

DAR File No.: 29148
Filed: 10/23/2006, 04:19
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The Centers for Medicare and Medicaid Services requires the Division of Health Care Financing (DHCF) to convert its Long-Term Care (LTC) Managed Care program to a 1915(c) home and community-based services waiver. DHCF therefore implements by rule the New Choices Waiver that allows LTC managed care to operate under the proper waiver authority.

Summary of the rule or change:

This rule incorporates by reference the New Choices Waiver that provides services to individuals who meet Medicaid eligibility criteria, nursing facility level of care criteria, and special targeting criteria. Waiver services include case management, homemaker services, adult day care, habilitation services, respite care, adult residential services, attendant care services, caregiver training, chore services, environmental accessibility adaptations, home delivered meals, institutional transition services, medication assistance services, personal emergency response system, specialized medical equipment and supplies, non-medical transportation, personal budget assistance, assistive technology devices, specialized behavioral health services, home health aide services, consumer preparation services, and financial management services.

State statutory or constitutional authorization for this rule:

Sections 26-18-3 and 26-1-5

This rule or change incorporates by reference the following material:

New Choices Waiver, effective January 1, 2007

Anticipated cost or savings to:

the state budget:

There is no budget impact because this amendment only transfers existing LTC managed care funds to the New Choices Waiver.

local governments:

There is no budget impact because no local funds are used to provide home and community-based services and local governments are not LTC providers.

other persons:

There is no budget impact because this amendment only transfers existing LTC managed care funds to the New Choices Waiver.

Compliance costs for affected persons:

There are no compliance costs because this amendment only transfers existing LTC managed care funds to the New Choices Waiver.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule change incorporates by reference the New Choices Waiver that allows LTC managed care to operate under the proper waiver authority. This is a requirement of federal law. David N. Sundwall, MD, Executive Director

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]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/15/2006

This rule may become effective on:

12/23/2006

Authorized by:

David N. Sundwall, Executive Director

RULE TEXT

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-61. Home and Community Based Waivers.

R414-61-2. Incorporation by Reference.

The Department adopts the document entitled "Utah State Plan under Title XIX of the Social Security Act" 1999 edition, and the document entitled "Home and Community Based Waiver Implementation Plan", 1999 edition, which are incorporated by reference within this rule. These documents are available for public inspection during normal working hours, at the State Health Department Building, located at 288 North, 1460 West, Salt Lake City, UT, 84114-3102, at the office of the Division of Health Care Financing. These documents will be used by the Division for the provision of services under the following waivers:

(1) Waiver for Technology Dependent/Medically Fragile Individuals, dated July 1, 2003;

(2) Waiver for Individuals Age 65 and Older, dated July 1, 2004;

(3) Waiver for Individuals with Acquired Brain Injuries, dated July 1, 2004;

(4) Waiver for Individuals with Physical Disabilities, dated July 1, 2003;

(5) Waiver for Individuals with Developmental Disabilities or Mental Retardation, dated July 1, 2003;

(6) New Choices Waiver, Effective January 1, 2007.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [February 1, 2005]2006

Notice of Continuation: March 11, 2005

Authorizing, and Implemented or Interpreted Law: 26-18-3