No. 37807 (5-year Review): Rule R414-55. Medicaid Policy for Hospital Emergency Department Copayment Procedures

DAR File No.: 37807
Filed: 06/28/2013 05:13:00 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 by rule policies for non-emergency services in outpatient hospital emergency settings. In addition, 42 CFR 447.51 through 447.58 set forth State Plan requirements and options for cost sharing, specify the standards and conditions for cost sharing, and set forth the cost sharing amounts and methods allowed under federal law.

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:

The Department will continue this rule because it defines emergency services to help Medicaid recipients and Medicaid providers to understand cost sharing responsibilities for non-emergency services. The Department will also continue this rule because it refers recipients and providers to copayment policy found in the Medicaid State Plan and in administrative rule.

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:

06/28/2013

---