Special Notice

In preparing the PDF version of the March 1, 2018, issue of the Utah State Bulletin, the Office of Administrative Rules inserted the text for Rule R414-518 after the rule analysis for Section R414-3A-5, Filing No. 42594. Rule R414-518, Filing No. 42595, was itself published correctly.

The text of Section R414-3A-5 and the fiscal analysis are below. This error does not change the timeline for Section R414-3A-5. The public comment period will end on 04/02/2018 and the first possible effective date is 04/09/2018.

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2018	FY 2019	FY 2020
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	Undetermined business revenue	Undetermined business revenue	Undetermined business revenue
Non-Small Businesses	Undetermined business revenue	Undetermined business revenue	Undetermined business revenue
Other Persons	Undetermined business revenue	Undetermined business revenue	Undetermined business revenue
Total Fiscal Benefits:	Undetermined business revenue	Undetermined business revenue	Undetermined business revenue
Net Fiscal Benefits:	Undetermined business revenue	Undetermined business revenue	Undetermined business revenue

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described above. Inestimable impacts for Non-Small Businesses are described below.

Appendix 2: Regulatory Impact to Non-Small Businesses

Businesses will see more revenue through the revised list of sleep accreditation organizations that now includes three organizations. Nevertheless, there are not sufficient nor cost effective data available to determine what those increases may be.

The Executive Director of the Department of Health, Joseph K. Miner, MD, has reviewed and approved this fiscal analysis.

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

R414-3A. Outpatient Hospital Services.

R414-3A-5. Services.

(1) Services appropriate in the outpatient hospital setting encompass medically necessary diagnostic, therapeutic, rehabilitative, or palliative medical services and supplies.

(2) Outpatient hospital services include:

(a) the service of nurses or other personnel necessary to complete the service and provide member care during the provision of service;

(b) the use of hospital facilities, equipment, and supplies; and

(c) the technical portion of clinical laboratory and radiology services.

(3) Cosmetic or reconstructive procedures are set forth in Section R414-1-29.

(4) [Sleep studies are available only in a sleep disorder center accredited by the American Academy of Sleep Medicine.]Coverage of sleep studies requires sleep center accreditation through one of the following nationally recognized accreditation organizations:

(a) American Academy of Sleep Medicine (AASM);

(b) Accreditation Commission for Health Care (ACHC); or

(c) The Joint Commission (TJC).

(5) Hyperbaric oxygen therapy is limited to service in a facility in which the hyperbaric unit is accredited by the Undersea and Hyperbaric Medical Society. Hyperbaric oxygen therapy is therapy that places the member in an enclosed pressure chamber for medical treatment.

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [July 1, 2017]2018

Notice of Continuation: September 15, 2017

Authorizing, and Implemented or Interpreted Law: 26-1-5; 26-18-2.3; 26-18-3(2); 26-18-4

This mistake does not appear in the HTML version of the Bulletin on the Office's website, https: rules.utah.gov. There, each rule analysis is published with the correct rule.

Direct questions regarding this rule to: Craig Devashrayee by phone at 801-538-6641, by FAX at 801-538-6099, or by E-mail at cdevashrayee@utah.gov or PO Box 143102, Salt Lake City, UT 84114-3102.

Questions regarding this error can be directed to: Nancy Lancaster by phone at 801-538-3218 or by E-mail at nllancaster@utah.gov.