R414-505-5. Requirements to Participate in the NF NSGO UPL Program

  (1)(a) The nursing care facility must be owned by an NSGE.

  (b) Prior to the Medicaid agency initiating a contract, the nursing care facility owner shall provide appropriate legal evidence, as determined by the Medicaid agency, demonstrating the nursing care facility is owned by an NSGE.

  (c) A nursing care facility participating in this supplemental payment program must notify the Reimbursement Unit within the Bureau of Coverage and Reimbursement Policy, at the address noted above, of changes in ownership that may affect the nursing care facility's continued eligibility within 14 calendar days after such change.

  (2) The Utah Medicaid provider enrollment process must be complete.

  (3)(a) The NSGE must have an NF NSGO UPL contract in effect, signed by the Utah Department of Health's authorized representative.

  (b) The effective date for an NF NSGO UPL contract for a nursing care facility to participate in the NF NSGO UPL supplemental payments shall be the latter of the following dates:

  (i) The effective date of the Change of Ownership (CHOW);

  (ii) The postmark date of the notice of intent to participate as noted in Section R414-505-4; or

  (iii) The effective date of the Medicaid provider enrollment.

  (4) Once a contract is in effect, the payments will be made in accordance with Attachment 4.19-D of the Medicaid State Plan and the NF NSGO UPL contract.

  (5)(a) State funding for supplemental payments authorized in this rule is limited to and obtained through Intergovernmental Transfer (IGT) Agreements of public funds or other permissible source-of-seed funding from the NSGE that holds the license and is party to the Medicaid contract of the nursing care facility.

  (b) The NSGE shall ensure that the funds provided to the Department for the non-federal share, via IGT, meet the requirements of 42 CFR 433, Subpart B.