Utah Administrative Code (Current through November 1, 2019) |
R414. Health, Health Care Financing, Coverage and Reimbursement Policy |
R414-1B. Payment for Limited Abortion Services |
R414-1B-4. Standards for Certification
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(1) Each provider who submits a certification is responsible to be informed of the abortion funding restrictions found in Section 76-7-331 and to assess whether it receives public funds for any abortion that is not excepted in Subsection 76-7-331(2)(a) or (b).
(2) A provider is not using public funds to directly or indirectly fund prohibited abortion services if the provider certifies:
(a) it uses non-public funds to make up any difference between the reimbursement the provider receives from all payors for services identified by abortion billing codes, other than those services identified in Subsection R414-1B-3(1), and the costs incurred by the provider for those procedures; or
(b) the provider has adopted another method, based on generally accepted accounting principles, which provides a good faith basis for supporting the certification.
(3) Each provider that submits a certification meeting the requirements of this rule shall maintain records to support the certification and make those records available to the Department on request consistent with participation as a Medicaid provider.