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Utah Administrative Code (Current through November 1, 2019) |
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R414. Health, Health Care Financing, Coverage and Reimbursement Policy |
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R414-309. Medicare Drug Benefit Low-Income Subsidy Determination |
| R414-309-1. Authority and Purpose |
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Latest version.
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(1) This rule is authorized by Title 26, Chapter18, UCA. (2) The Medicare Modernization Act requires the state to have the ability, upon request, to determine eligibility for the Medicare drug benefit low-income subsidies as set forth in 42 CFR 423.904. This rule sets forth the requirements for completing eligibility determinations for the Medicare Part D low-income subsidies. |
| R414-309-2. General Provisions |
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Latest version.
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(1) The Utah Department of Health shall make Medicare Part D Subsidy applications from the Social Security Administration available at State Medical Assistance Offices to individuals who want to apply for the Medicare drug benefit low-income subsidies, and may help individuals complete and send the form to the Social Security Administration. (2) The Department shall apply the eligibility criteria for the Medicare drug benefit low-income subsidy programs as defined in 42 CFR 423.904 in making any determinations that the state is required to make and shall notify the applicant of that decision. (3) If the Department determines that an applicant is not eligible for a Medicare drug benefit low-income subsidy, the applicant may appeal the Department's decision pursuant to the provisions of R410-14. (4) As required by 42 CFR 423.904, the Department exchanges information on Medicare Part D subsidy applicants and eligible individuals with the Centers for Medicare and Medicaid Services and with the Social Security Administration. |