No. 26955 (Amendment): R414-1-5. State Plan

DAR File No.: 26955
Filed: 02/24/2004, 11:10
Received by: NL

 

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule change updates the incorporation of the Utah Medicaid State Plan.

 

Summary of the rule or change:

This rule change updates the incorporation by reference of the Utah Medicaid State Plan into Rule R414-1 to the plan effective December 31, 2003. There have been three State Plan Amendments approved since this rule was last amended, which were the result of increased Legislative appropriations. State Plan Amendment 03-009-UT Speech Pathology Services extends speech pathology services to non-pregnant adults ages 21 and older. State Plan Amendment 03-012-UT Audiology Services extends audiology services to non-pregnant adults ages 21 and older. State Plan Amendment 03-017-UT Aged and Disabled Spenddown Level adds an income deduction for aged, blind and disabled individuals who qualify as medically needy that has the effect of allowing them to spenddown to 100% of the federal poverty guideline. Each of these changes is also implemented by separate, specific rule.

 

State statutory or constitutional authorization for this rule:

Section 26-18-3

 

This rule or change incorporates by reference the following material:

Utah State Medicaid Plan, December 31, 2003

 

Anticipated cost or savings to:

the state budget:

State Plan Amendment 03-009-UT Speech Pathology Services cost $5,667 federal dollars and $2,322 in state dollars in federal FY 2003 and will cost $22,667 and $8,990 in state funds in federal FY 2004. State Plan Amendment 03-012-UT Audiology Services cost $95,000 in federal dollars and $38,935 in state dollars in federal FY 2003 and will cost $380,000 in federal funds and $152,150 in state funds in federal FY 2004. The costs for State Plan Amendment 03-017-UT Aged and Disabled Spenddown Level were explained in DAR File No. 26202, published on May 15, 2003, and in DAR File No. 26781, published on December 1, 2003. All of these costs are handled within appropriations for the state Medicaid program.

 

local governments:

There is no cost to local governments because local governments do not operate any of the programs approved since this rule was last amended.

 

other persons:

Medicaid recipients will receive additional services equal to the estimated costs to the state budget.

 

Compliance costs for affected persons:

Medicaid recipients will receive additional services equal to the estimated costs to the state budget.

 

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

H.B. 126 passed in the 2003 Legislative session and which took effect May 5, 2003, deleted a reference in Title 26, Chapter 18, which previously authorized implementation of the Utah Medicaid program through policy rather than rule. In order to comply with HB 126, each calendar quarter the Utah Medicaid program files a rulemaking to incorporate the current Medicaid State Plan by reference. The state plan and rule changes reflected in this incorporation have a positive fiscal impact on businesses that accept Medicaid clients. Scott D. Williams, MD (DAR Note: H.B. 126 is found at UT L 2003 Ch 324, and was effective May 5, 2003.)

 

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:

Ross Martin at the above address, by phone at 801-538-6592, 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:

04/14/2004

 

This rule may become effective on:

04/15/2004

 

Authorized by:

Scott D. Williams, Executive Director

 

 

RULE TEXT

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

R414-1. Utah Medicaid Program.

R414-1-5. State Plan.

(1) As a condition for receipt of federal funds under title XIX of the Act, the Utah Department of Health must submit a State Plan contract to the federal government for the medical assistance program, and agree to administer the program in accordance with the provisions of the State Plan, the requirements of Titles XI and XIX of the Act, and all applicable federal regulations and other official issuances of the United States Department of Health and Human Services. A copy of the State Plan is available for public inspection at the Division's offices during regular business hours.

(2) The department adopts the Utah State Plan Under Title XIX of the Social Security Act Medical Assistance Program, in effect [May]December 1, 2003, which is incorporated by reference.

 

KEY: Medicaid

[November 26, 2003]2004

Notice of Continuation April 30, 2002

26-1-5

26-18-1