DAR File No. 42183

Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-514-2

Requirements for Additional Nursing Care Facility Programs or Additional Beds Within an Existing Program

Notice of Proposed Rule

(Amendment)

DAR File No.: 42183
Filed: 10/02/2017 05:25:31 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to clarify the authority under which Medicaid nursing facilities can meet certification requirements.

Summary of the rule or change:

This amendment updates a citation in the rule text to provide nursing facilities further clarification on certification requirements.

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 no impact to the state budget because this change only clarifies a reference to program certification.

local governments:

There is no cost to local governments because they do not fund nursing facilities under the Medicaid program.

small businesses:

There is no impact to small businesses because this change only clarifies a reference to program certification.

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

There is no impact to Medicaid providers or to Medicaid members because this change only clarifies a reference to program certification.

Compliance costs for affected persons:

There are no compliance costs to a single Medicaid provider or to a Medicaid member because this change only clarifies a reference to program certification.

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

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to businesses.

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:

11/14/2017

This rule may become effective on:

12/01/2017

Authorized by:

Joseph Miner, Executive Director

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

R414-514. Requirements for Moratorium Exception.

R414-514-2. 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]Section 26-18-503 to acquire additional nursing care facility programs[, and must meet the requirements of Subsection 26-18-503(5)] or 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: [July 1], 2017

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