DAR File No. 41588

Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-100

Medicaid Primary Care Network Services

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 41588
Filed: 05/05/2017 10:38:47 AM

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 of Health to implement the Medicaid program through administrative rules. Additionally, Section 26-1-5 authorizes the Department to adopt rules that provide services under the Primary Care Network (PCN), and Section 1115 of the Social Security Act authorizes these services under a waiver of federal Medicaid requirements.

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 did not receive any written or oral comments regarding this rule.

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 emergency services, spells out services available to PCN members, and includes member cost-sharing provisions.

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

Effective:

05/05/2017

Authorized by:

Joseph Miner, Executive Director