DAR File No. 41125
This notice was published in the February 1, 2017, issue (Vol. 2017, No. 3) of the Utah State Bulletin.
Health, Health Care Financing, Coverage and Reimbursement Policy
Transplant Services Standards
Five-Year Notice of Review and Statement of Continuation
DAR File No.: 41125
Filed: 01/06/2017 12:20:19 PM
NOTICE OF REVIEW AND STATEMENT OF CONTINUATION
Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:
Section 26-18-3 requires the Department to implement Medicaid policy through administrative rules, which allow the Department to administer the Medicaid program. Additionally, Section 26-1-5 allows the Department to adopt rules that provide access to Medicaid services, and 42 CFR 482.68 sets forth special requirements for transplant service centers.
Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:
The Department received written comments from Molina Health Care, National Marrow Donor Program, Intermountain Health Care, and University of Utah Health Care, after filing a notice of repeal and reenactment for this rule to clarify Medicaid policy in June 2016. The comments reflected concerns over coverage for stem cell transplant services that include research, searches for donors, and requests to expand coverage for various childhood illnesses that may be responsive to stem cell treatment.
Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:
The Department will continue this rule because it defines important terms and provisions, sets forth eligibility and access requirements, specifies service coverage and prior authorization, clarifies covered and non-covered services for stem cell transplantation, and lists criteria for requests of non-covered services. There is no opposition to the rule itself and the Department filed a change in proposed rule that addresses the written comments and makes other clarifications.
The full text of this rule may be inspected, during regular business hours, at the Office 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 firstname.lastname@example.org
Joseph Miner, Executive Director
More information about a Five-Year Notice of Review and Statement of Continuation 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/2017/b20170201.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 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 email@example.com. For questions about the rulemaking process, please contact the Office of Administrative Rules.