Special Notice

This notice was published in the August 1, 2014, issue (Vol. 2014, No. 15) of the Utah State Bulletin.

Special Notice: Notice for Amendments to the August 2014 Primary Care Network (PCN) Waiver

The Utah Department of Health, Division of Medicaid and Health Financing requests the following amendments to the 1115 Primary Care Network Medicaid Waiver.

Amendment #12: The purpose of this amendment is to modify the maximum income eligibility for Demonstration Population I (individuals age 19-64) from gross family countable income at or below 100% of the Federal Poverty Level (FPL) to gross family income at or below 95% of the FPL to eliminate the "donut hole" created by implementation of the Federal Facilitated Marketplace (FFM), the new Modified Adjusted Gross Income (MAGI) income eligibility methodology and Utah's 1115 Primary Care Network Waiver for some of Utah's most needy citizens.

Amendment #13: The Affordable Care Act extends insurance coverage to children who are enrolled in their parents insurance up to age 26. The purpose of this amendment is to add a new eligibility group comprised of adult children of individuals eligible for premium assistance under Utah's Premium Partnership for Health Insurance (UPP) program, who:

--Are age 19 through 26;

--Are United States citizens/legal residents;

--Are residents of the state of Utah;

--Are not otherwise eligible for Medicaid, Medicare, or Veteran's Benefits;

--Have no other health insurance;

--Live in their parents' household;

--Are enrolled in their parents' employer sponsored insurance; and

--To allow premium assistance using Title XIX funds for this new Demonstration Population.

These amendments are subject to Centers for Medicare and Medicaid Services (CMS) approval. For questions regarding this notice, please contact Emma Chacon at 801-538-6577 or echacon@utah.gov.


Additional Information

The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2014/b20140801.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.

For questions regarding this notice, please contact Craig Devashrayee, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov.