R414-1-5. Incorporations by Reference

  The Department incorporates the January 2018 versions of the following by reference:

  (1) Utah Medicaid State Plan, including any approved amendments, under Title XIX of the Social Security Act Medical Assistance Program;

  (2) Medical Supplies and Durable Medical Equipment Utah Medicaid Provider Manual, as applied in Rule R414-70, and the manual's attachment for Donor Human Milk Request Form;

  (3) Hospital Services Utah Medicaid Provider Manual with its attachments;

  (4) Home Health Agencies Utah Medicaid Provider Manual, and the manual's attachment for the Private Duty Nursing Acuity Grid;

  (5) Speech-Language Pathology and Audiology Services Utah Medicaid Provider Manual;

  (6) Hospice Care Utah Medicaid Provider Manual;

  (7) Long Term Care Services in Nursing Facilities Utah Medicaid Provider Manual with its attachments;

  (8) Personal Care Utah Medicaid Provider Manual;

  (9) Utah Home and Community-Based Waiver Services for Individuals Age 65 or Older Utah Medicaid Provider Manual;

  (10) Utah Home and Community-Based Waiver Services for Individuals with an Acquired Brain Injury Utah Medicaid Provider Manual;

  (11) Utah Community Supports Waiver for Individuals with Intellectual Disabilities or Other Related Conditions Utah Medicaid Provider Manual;

  (12) Utah Home and Community-Based Services Waiver for Individuals with Physical Disabilities Utah Medicaid Provider Manual;

  (13) Utah Home and Community-Based Waiver Services New Choices Waiver Utah Medicaid Provider Manual;

  (14) Utah Home and Community-Based Services Waiver for Technology Dependent, Medically Fragile Individuals Utah Medicaid Provider Manual;

  (15) Utah Home and Community-Based Waiver Services Medicaid Autism Waiver Utah Medicaid Provider Manual;

  (16) Office of Inspector General Administrative Hearings Procedures Manual;

  (17) Pharmacy Services Utah Medicaid Provider Manual with its attachments;

  (18) Drug Criteria and Limits Policy;

  (19) Coverage and Reimbursement Code Look-up Tool found at http://health.utah.gov/medicaid/stplan/lookup/CoverageLookup.php;

  (20) CHEC Services Utah Medicaid Provider Manual with its attachments;

  (21) Dental, Oral Maxillofacial, and Orthodontia Services Utah Medicaid Provider Manual;

  (22) General Attachments (All Providers) for the Utah Medicaid Provider Manual;

  (23) Indian Health Utah Medicaid Provider Manual;

  (24) Medical Transportation Utah Medicaid Provider Manual;

  (25) Non-Traditional Medicaid Plan Utah Medicaid Provider Manual with attachment;

  (26) Licensed Nurse Practitioner Utah Medicaid Provider Manual;

  (27) Physical Therapy and Occupational Therapy Services Utah Medicaid Provider Manual, and the manual's attachment for Physical Therapy and Occupational Therapy Decision Tables;

  (28) Physician Services Utah Medicaid Provider Manual with its attachments;

  (29) Podiatric Services Utah Medicaid Provider Manual;

  (30) Primary Care Network Utah Medicaid Provider Manual with its attachments;

  (31) Rehabilitative Mental Health and Substance Use Disorder Services Utah Medicaid Provider Manual;

  (32) Rural Health Clinics and Federally Qualified Health Centers Services Utah Medicaid Provider Manual;

  (33) School-Based Skills Development Services Utah Medicaid Provider Manual;

  (34) Section I: General Information Utah Medicaid Provider Manual;

  (35) Targeted Case Management for Individuals with Serious Mental Illness Utah Medicaid Provider Manual;

  (36) Targeted Case Management for Early Childhood (Ages 0-4) Utah Medicaid Provider Manual;

  (37) Vision Care Services Utah Medicaid Provider Manual;

  (38) Medically Complex Children's Waiver Utah Medicaid Provider Manual; and

  (39) Autism Spectrum Disorder Related Services for EPSDT Eligible Individuals Utah Medicaid Provider Manual.