DAR File No. 38466

Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-306

Program Benefits and Date of Eligibility

Notice of Proposed Rule

(Amendment)

DAR File No.: 38466
Filed: 04/28/2014 10:08:43 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to specify when coverage ends for the Qualified Individuals (QI) program in accordance with Pub. L. No. 113-93.

Summary of the rule or change:

This amendment specifies when coverage ends for the QI program.

State statutory or constitutional authorization for this rule:

• Section 26-1-5
• Pub. L. No. 113-93
• Section 26-18-3

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because this amendment does not affect services or eligibility for Medicaid recipients, and only specifies the duration of coverage for the QI program.

local governments:

There is no impact to local governments because they do not fund or provide Medicaid services to Medicaid recipients.

small businesses:

There is no impact to small businesses because this amendment does not affect services or eligibility for Medicaid recipients, and only specifies the duration of coverage for the QI program.

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

There is no impact to Medicaid providers and to Medicaid recipients because this amendment does not affect services or eligibility, and only specifies the duration of coverage for the QI program.

Compliance costs for affected persons:

There is no impact to a single Medicaid provider or to a Medicaid recipient because this amendment does not affect services or eligibility, and only specifies the duration of coverage for the QI program.

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

No impact on business as it merely conforms the rule to new legal requirements.

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:

06/16/2014

This rule may become effective on:

07/01/2014

Authorized by:

David Patton, Executive Director

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

R414-306. Program Benefits and Date of Eligibility.

R414-306-2. QMB, SLMB, and QI Benefits.

(1) The Department must provide the services outlined under 42 U.S.C. 1396d(p) and 42 U.S.C. 1396u-3 for Qualified Medicare Beneficiaries.

(2) The Department provides the benefits outlined under 42 U.S.C. 1396d(p)(3)(ii) for Specified Low-Income Medicare Beneficiaries and Qualifying Individuals. Benefits for Qualifying Individuals are subject to the provisions of 42 U.S.C. 1396u-3.

(3) The Department does not cover premiums for enrollment with any health insurance plans except for Medicare.

(4) Pub. L. No. 113 93 requires the Qualifying Individuals program to end after March 31, 2015.

 

KEY: effective date, program benefits, medical transportation

Date of Enactment or Last Substantive Amendment: [January 10, ]2014

Notice of Continuation: January 23, 2013

Authorizing, and Implemented or Interpreted Law: 26-18