Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-310

Medicaid Primary Care Network Demonstration Waiver

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 36309
Filed: 06/04/2012 01:53:47 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Section 26-18-3 requires the Department to implement Medicaid policy through administrative rules, which allow the Department to administer the Primary Care Network (PCN) Demonstration Waiver. In addition, Section 26-1-5 authorizes the Department to adopt rules that provide services to PCN recipients. Section 1115(a) of the Social Security Act also authorizes services to PCN recipients under a waiver of federal Medicaid requirements.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department did not receive any written or oral comments regarding this rule.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule is necessary because it implements the PCN Demonstration Waiver to provide services to PCN recipients. It is also necessary because it establishes eligibility requirements for waiver enrollment, specifies program rights and responsibilities, specifies service limitations, provides application procedures, and contains notice and termination provisions. Therefore, this rule should be continued.

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

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

Authorized by:

David Patton, Executive Director

Effective:

06/04/2012