DAR File No. 39414

Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-306-2

QMB, SLMB, and QI Benefits

Notice of Proposed Rule

(Amendment)

DAR File No.: 39414
Filed: 06/01/2015 10:59:16 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 Qualifying Individual (QI) 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 QI 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

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]shall 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 shall provide[s] 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: [July 1, 2014]2015

Notice of Continuation: January 23, 2013

Authorizing, and Implemented or Interpreted Law: 26-18