DAR File No. 41561

Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-514

Requirements for Moratorium Exception

Notice of Proposed Rule

(New Rule)

DAR File No.: 41561
Filed: 05/01/2017 05:42:21 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this rule is to implement provisions of H.B. 113 passed during the 2017 General Session, which set forth moratorium exception requirements for Medicaid-certified nursing facility programs.

Summary of the rule or change:

Under the Moratorium Exception, this new rule implements requirements that a Medicaid-certified nursing facility program must meet for certification of additional nursing care facility programs, or for certification of additional beds within an existing nursing care facility program.

Statutory or constitutional authorization for this rule:

• Section 26-18-503
• Section 26-18-3

Anticipated cost or savings to:

the state budget:

There is an expected annual cost of about $1,800 to cover the licensing fees of a new nursing facility. Nevertheless, there is no way to estimate the total cost to the state budget without knowing the number of facilities that will become licensed under the new legislation.

local governments:

There is no impact to local governments because they neither fund nor certify nursing facility programs under the Medicaid program.

small businesses:

Each new small business may see an annual increase in cost of about $1,800 to operate a skilled nursing facility. Nevertheless, there is no way to estimate the total cost to small businesses without knowing the number of facilities that will become licensed under the new legislation.

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

Each new nursing care facility provider may see an annual increase in cost of about $1,800 to operate a skilled nursing facility under the new legislation. Nevertheless, there is no way to estimate the total cost to nursing facilities without knowing the number of facilities that will become licensed. Medicaid members will not see any out-of-pocket expenses associated with this rulemaking.

Compliance costs for affected persons:

A single nursing care facility provider may see an annual increase in cost of about $1,800 to operate a skilled nursing facility under the new legislation.

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

This amendment fiscally impacts business by increasing licensing fees for new Medicaid nursing care facilities.

Joseph K. Miner, MD, Executive Director

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 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:

06/14/2017

This rule may become effective on:

07/01/2017

Authorized by:

Joseph Miner, Executive Director

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

R414-514. Requirements for Moratorium Exception.

R414-514-1. Introduction and Authority.

(1) This rule implements requirements that a Medicaid-certified nursing facility program must meet for certification of additional nursing care facility programs, or for certification of additional beds within an existing nursing care facility program.

(2) This rule is authorized under Sections 26-18-3, 26-18-5, and 26-18-503.

 

R414-514-2. Requirements for Additional Nursing Care Facility Programs or Additional Beds Within an Existing Program.

(1) A Medicaid-certified nursing care facility program must meet the requirements of Rule R414-27 to acquire additional nursing care facility programs, and must meet the requirements of Subsection 26-18-503(5) to acquire additional beds.

(2) Pursuant to Subsection 26-18-503(5), a nursing care facility program must provide all necessary information on the Utah Medicaid Nursing Facility Moratorium Exception Application. The Division of Medicaid and Health Financing (DMHF) shall return the application to the requestor if the application or supporting documentation is deficient.

(3) The notice date shall be the postmark date or other proof of delivery for the application mailed to DMHF.

(4) If DMHF receives an application for the Utah Medicaid Nursing Facility Moratorium Exception in a rural county, and a Medicaid-certified nursing facility program does not meet the quality standards pursuant to Subsection 26-18-503(5)(d)(v), the certified program may provide additional information under Subsection 26-18-503(9)(a)(ii). Any additional information submitted to DMHF must be postmarked or have other proof of delivery information within 14 days of the original notice from DMHF. Electronic mail (email) does not meet the notification requirement.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: 2017

Authorizing, and Implemented or Interpreted Law: 26-18-3; 26-18-503