DAR File No. 37546

Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-1-30

Governing Hierarchy

Notice of Proposed Rule

(Amendment)

DAR File No.: 37546
Filed: 04/29/2013 08:58:21 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This change is necessary to comply with H.B. 106, 2013 General Session, which requires the Office of Inspector General of Medicaid Services (OIG) to identify conflicts between the Medicaid State Plan, Department administrative rules, Medicaid provider manuals, and Medicaid Information Bulletins (MIBs), and to recommend that the Department reconcile inconsistencies.

Summary of the rule or change:

Section R414-1-30 is removed in its entirety to defer to provisions set forth in H.B. 106, 2013 General Session, which require OIG to identify conflicts between the Medicaid State Plan, Department administrative rules, Medicaid provider manuals, and MIBs, and to recommend that the Department reconcile inconsistencies.

State statutory or constitutional authorization for this rule:

• Section 26-18-3
• Section 26-1-5

Anticipated cost or savings to:

the state budget:

There is no fiscal impact because the review requirements in H.B. 106 do not create administrative costs to either the Department or OIG.

local governments:

There is no fiscal impact to local governments because they neither fund nor provide Medicaid services to Medicaid recipients.

small businesses:

There is no fiscal impact because the review requirements in H.B. 106 do not apply to small businesses.

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

The Department does not expect a fiscal impact to providers and recipients because any inconsistencies that could arise should not affect provider reimbursement or Medicaid services.

Compliance costs for affected persons:

The Department does not expect a fiscal impact to a single provider or recipient because any inconsistencies that could arise should not affect provider reimbursement or Medicaid services.

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

This change should have no effect on business as it will not change reimbursement rates.

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
CANNON HEALTH BLDG
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:

06/14/2013

This rule may become effective on:

07/01/2013

Authorized by:

David Patton, Executive Director

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

[R414-1-30. Governing Hierarchy.

(1) The Utah Medicaid State Plan under Title XIX of the Social Security Act Medical Assistance Program and any Waivers to that State Plan ("State Plan") shall be the governing authority for implementing the Medicaid program to the extent incorporated by rule. If a conflict exists between a Waiver and the Utah Medicaid State Plan, the Waiver shall govern.

(2) If an administrative rule addresses an issue that is not fully addressed by the State Plan, the administrative rule adopted by the Department shall govern the implementation of the Medicaid program, after giving full effect to the State Plan.

(3) Statements or actions by department employees shall not constitute exceptions or waivers to the governing authority of Subsection R414-1-30 (1) or (2).

 

]KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [March 1, ]2013

Notice of Continuation: March 2, 2012

Authorizing, and Implemented or Interpreted Law: 26-1-5; 26-18-3; 26-34-2