Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-59-4

Client Eligibility Requirements

Notice of Proposed Rule

(Amendment)

DAR File No.: 34086
Filed: 09/15/2010 01:10:50 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to incorporate by reference the Audiology Services Provider Manual, effective 10/01/2010.

Summary of the rule or change:

This change incorporates by reference the Audiology Services Provider Manual, effective 10/01/2010.

State statutory or constitutional authorization for this rule:

• Section 26-18-3

This rule or change incorporates by reference the following material:

• Updates Audiology Services Provider Manual, published by Division of Medicaid and Health Financing, 10/01/2010

Anticipated cost or savings to:

the state budget:

There is no budget impact because the incorporation of ongoing Medicaid policy described in the Audiology Services Provider Manual does not create costs or savings to the Department or other state agencies.

local governments:

This change does not impact local governments because they do not fund or provide audiology services to Medicaid clients.

small businesses:

There is no budget impact because the incorporation of ongoing Medicaid policy described in the Audiology Services Provider Manual does not create costs or savings to small businesses.

persons other than small businesses, businesses, or local governmental entities:

There is no budget impact because the incorporation of ongoing Medicaid policy described in the Audiology Services Provider Manual does not create costs or savings to other persons or entities.

Compliance costs for affected persons:

There are no compliance costs because the incorporation of ongoing Medicaid policy described in the Audiology Services Provider Manual does not create additional costs to a Medicaid client or a loss of revenue to a Medicaid provider.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule should not have a direct fiscal impact on business. Incorporation of this section of the Provider Manual by this rule assures that the Medicaid program is implemented through administrative rule.

David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [email protected]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

11/01/2010

This rule may become effective on:

11/08/2010

Authorized by:

David Sundwall, Executive Director

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-59. Audiology-Hearing Services.

R414-59-4. Client Eligibility Requirements.

(1) Audiology-hearing services are available only to clients who are pregnant women or who are individuals eligible under the Early and Periodic Screening, Diagnosis and Treatment Program.

(2) An individual receiving audiology-hearing services may receive audiology services as described in the Audiology Services Provider Manual, effective [July]October 1, 2010, which is incorporated by reference.

(3) An individual receiving audiology-hearing services must meet the criteria established in the Audiology Services Provider Manual and obtain prior approval if required.

 

KEY: Medicaid, audiology

Date of Enactment or Last Substantive Amendment: [August 31], 2010

Notice of Continuation: November 22, 2005

Authorizing, and Implemented or Interpreted Law: 26-1-5; 26-18-3