DAR File No. 39413

This rule was published in the June 15, 2015, issue (Vol. 2015, No. 12) of the Utah State Bulletin.


Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-303-6

12-Month Transitional Medicaid

Notice of Proposed Rule

(Amendment)

DAR File No.: 39413
Filed: 06/01/2015 10:49:46 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to remove the sunset date for the 12-Month Transitional Medicaid program in accordance with the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015, Pub. L. No. 114-10.

Summary of the rule or change:

This amendment removes the sunset date for the 12-Month Transitional Medicaid program, thereby extending the program indefinitely. It also makes other clarifications.

State statutory or constitutional authorization for this rule:

  • Section 26-1-5
  • Pub. L. No. 114-10
  • Section 26-18-3

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because funding for this program has already been appropriated by the legislature.

local governments:

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

small businesses:

There is no additional impact to small businesses because they will continue to see revenue through this program.

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

There is no additional impact to Medicaid providers because they will continue to see revenue through this program. Medicaid recipients who qualify for the program will also continue to see savings.

Compliance costs for affected persons:

There are no compliance costs to a single Medicaid provider who will see only revenue through this program. Likewise, there are no out-of-pocket expenses to a single Medicaid recipient who will see only savings.

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

There is no impact to business because it does not change compliance costs to Medicaid providers.

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:

07/15/2015

This rule may become effective on:

08/01/2015

Authorized by:

David Patton, Executive Director

RULE TEXT

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

R414-303. Coverage Groups.

R414-303-6. 12-Month Transitional Medicaid.

[(1) ]The Department [adopts and incorporates by reference Title XIX of the Social Security Act Section 1925 in effect January 1, 2013, to]shall provide 12 months of extended medical assistance as set forth in 42 U.S.C. 1396r-6, when the parent or caretaker relative is eligible and enrolled in Medicaid as defined in 42 CFR 435.110, and loses eligibility as described in Subsection 1931(c)(2) of the Social Security Act.

([a]1) A pregnant woman who is eligible and enrolled in Medicaid as defined in 42 CFR 435.116, and who meets the income limit defined in 42 CFR 435.110 for three of the prior six months, is eligible to receive 12-month Transitional Medicaid.

([b]2) Children who live with the parent are eligible to receive Transitional Medicaid.

[(2) Pub. L. No. 113 93 requires the Transitional Medicaid program to end after March 31, 2015.

]

KEY: MAGI-based, coverage groups, former foster care youth, presumptive eligibility

Date of Enactment or Last Substantive Amendment: [May 8, ]2015

Notice of Continuation: January 23, 2013

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

 


Additional Information

More information about a Notice of Proposed Rule is available online.

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/2015/b20150615.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.

Text to be deleted is struck through and surrounded by brackets ([example]). Text to be added is underlined (example).  Older browsers may not depict some or any of these attributes on the screen or when the document is printed.

For questions regarding the content or application of this rule, please contact 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.  For questions about the rulemaking process, please contact the Division of Administrative Rules.