No. 35720 (5-year Review): Rule R414-10. Physician Services

DAR File No.: 35720
Filed: 01/24/2012 10:12:53 AM

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 allows the Department to adopt administrative rules that provide services to Medicaid clients. Further, 42 CFR 440.50 allows the Department to provide physician services for Medicaid clients that fall within a physician's scope of practice.

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 sets forth eligibility requirements for Medicaid clients to receive physician services, sets forth program access requirements for physicians, specifies service coverage criteria, and directs Medicaid clients to the Department's copayment policy. 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:

01/24/2012

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