Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-14

Home Health Services

Notice of Proposed Rule

(Amendment)

DAR File No.: 34994
Filed: 06/30/2011 09:05:34 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to incorporate by reference the definitions from the home health agency provider manual to 07/01/2011.

Summary of the rule or change:

This amendment incorporates by reference the definitions from the home health agency provider manual to 07/01/2011.

State statutory or constitutional authorization for this rule:

• Section 26-18-3
• Section 26-1-5

This rule or change incorporates by reference the following material:

• Updates Home Health Agency Provider Manual, published by Division of Medicaid and Health Financing, 07/01/2011

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because this change only updates the incorporation of definitions in the home health agency provider manual.

local governments:

There is no impact to local governments because they do not fund or provide home health services for Medicaid clients.

small businesses:

There is no impact to small businesses because this change only updates the incorporation of definitions in the home health agency provider manual.

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

There is no impact to Medicaid clients and to Medicaid providers because this change only updates the incorporation of definitions in the home health agency provider manual.

Compliance costs for affected persons:

There are no compliance costs to a single Medicaid client or to a Medicaid provider because this change only updates the incorporation of definitions in the home health agency provider manual.

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

This update assures that providers and recipients know what current requirements are applicable. Clarity should have a positive fiscal impact.

W. David Patton, PhD, 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 cdevashrayee@utah.gov

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:

08/15/2011

This rule may become effective on:

08/22/2011

Authorized by:

David Patton, Executive Director

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

R414-14. Home Health Services.

R414-14-1. Introduction and Authority.

(1) Home health services are part-time intermittent health care services that are based on medical necessity and provided to eligible persons in their places of residence when the home is the most appropriate and cost effective setting that is consistent with the client's medical need. The goals of home health care are to minimize the effects of disability or pain; promote, maintain, or protect health; and prevent premature or inappropriate institutionalization.

(2 )[.] This rule is authorized under Section 26-18-3 and governs the services allowed under 42 CFR 440.70 and 42 CFR, Part 484. 42 U.S.C. Secs. 1395u, 1395x, and 1395y also authorize home health services.

 

R414-14-2. Definitions.

The following definition applies to home health services. In addition, the Department incorporates by reference the definitions in the Home Health Agency Provider Manual, effective [April]July 1, 2011.

(1) "Plan of Care" means a written plan developed cooperatively by home health agency staff and the attending physician. The plan is designed to meet specific needs of an individual, is based on orders written by the attending physician, and is approved and periodically reviewed and updated by the attending physician.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [May 25,] 2011

Notice of Continuation: September 23, 2009

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