Summary


Section R414-1-5 is changed to incorporate the Utah Medicaid State Plan and an approved state plan amendment (SPA) by reference to 04/01/2015. This SPA includes: SPA 15-0001-UT Telehealth Services, which removes all provisions of coverage and reimbursement for telehealth services from the state plan because telehealth is not a distinct service but rather a method of service delivery. This rule change also incorporates by reference the Medical Supplies Utah Medicaid Provider Manual, and the manual's attachment for Donor Human Milk Request Form, effective 04/01/2015; incorporates by reference the Hospital Services Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Home Health Agencies Utah Medicaid Provider Manual, and the manual's attachment for the Private Duty Nursing Acuity Grid, effective 04/01/2015; incorporates by reference the Speech-Language Pathology and Audiology Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Hospice Care Utah Medicaid Provider Manual, and the manual's attachment for the Utah Medicaid Prior Authorization Request for Hospice Services, effective 04/01/2015; incorporates by reference the Long Term Care Services in Nursing Facilities Utah Medicaid Provider Manual, with its attachments, effective 04/01/2015; incorporates by reference the Utah Home and Community-Based Waiver Services for Individuals Age 65 or Older Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Personal Care Utah Medicaid Provider Manual, and the manual's attachment for the Request for Prior Authorization: Personal Care and Capitated Programs effective 04/01/2015; incorporates by reference the Utah Home and Community-Based Waiver Services for Individuals with an Acquired Brain Injury Utah Medicaid Provider Manual, effective 04/01/2015; Utah Community Supports Waiver for Individuals with Intellectual Disabilities or Other Related Conditions Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Utah Home and Community-Based Services Waiver for Individuals with Physical Disabilities Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Utah Home and Community-Based Waiver Services New Choices Waiver Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Utah Home and Community-Based Services Waiver for Technology Dependent, Medically Fragile Individuals Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Utah Home and Community-Based Waiver Services Medicaid Autism Waiver Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Office of Inspector General (OIG) Administrative Hearings Procedures Manual, effective 04/01/2015; incorporates by reference the Pharmacy Services Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Coverage and Reimbursement Code Look-up Tool, effective 04/01/2015; incorporates by reference the CHEC Services Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Chiropractic Medicine Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Dental, Oral Maxillofacial, and Orthodontia Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the General Attachments (All Providers) for the Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Indian Health Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Laboratory Services Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Medical Transportation Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Non-Traditional Medicaid Plan Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Licensed Nurse Practitioner Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Physical Therapy and Occupational Therapy Services Utah Medicaid Provider Manual, and the manual's attachment for Physical Therapy and Occupational Therapy Decision Tables, effective 04/01/2015; incorporates by reference the Physician Services, Anesthesiology and Laboratory Services Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Podiatric Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Primary Care Network Utah Medicaid Provider Manual with its attachments, effective 04/01/2015; incorporates by reference the Psychology Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Rehabilitative Mental Health and Substance Use Disorder Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Rural Health Clinics and Federally Qualified Health Centers Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the School-Based Skills Development Services Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference Section I: General Information Utah Medicaid Provider Manual, effective 04/01/2015; incorporates by reference the Targeted Case Management for Individuals with Serious Mental Illness Utah Medicaid Provider Manual, effective 04/01/2015; Targeted Case Management for Early Childhood (Ages 0-4) Utah Medicaid Provider Manual, effective 04/01/2015; Vision Care Services Utah Medicaid Provider Manual, effective 04/01/2015; and Women's Services Utah Medicaid Provider Manual, effective 04/01/2015.