DAR File No. 28698

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-303-7

Foster Care

NOTICE OF PROPOSED RULE

DAR File No.: 28698
Filed: 05/01/2006, 10:53
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rulemaking is needed to add a Medicaid coverage group of independent foster care adolescents who are age 18 but not yet 21. This is to comply with H.B. 288 passed by the Utah State Legislature in its 2006 General Session. (DAR NOTE: H.B. 288 (2006) is found at Chapter 110, Laws of Utah 2006, and was effective 05/01/2006.)

Summary of the rule or change:

In Section R414-303-7, this change adds a new coverage group of independent foster care adolescents and defines the criteria for Medicaid eligibility for the group.

State statutory or constitutional authorization for this rule:

Section 26-18-403

1902(a)(10)(A)(ii)(XVII) of the Social Security Act

Anticipated cost or savings to:

the state budget:

The state anticipates the annual cost to be about $1,514,500 of which $450,000 are state funds and $1,064,500 are federal funds.

local governments:

There is no impact on local governments, because local governments do not determine eligibility for Medicaid.

other persons:

There are no anticipated costs to others. Individuals who qualify for services under this new coverage group could save up to $1,514,500 in medical expenses they would otherwise have to pay for themselves. Medicaid providers will receive up to $1,514,500 for services they perform for Medicaid patients extended coverage by this rule.

Compliance costs for affected persons:

There are no compliance costs because this rulemaking does not require individuals who meet the criteria for coverage to pay anything to receive this coverage. This rulemaking does not impose any costs on individuals, businesses, or other government agencies.

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

This rule implements H.B. 288 which extends Medicaid coverage to young adults who were in foster care upon becoming adults. It provides additional funding to pay health care providers. A. Richard Melton, Acting Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

Ross Martin at the above address, by phone at 801-538-6592, by FAX at 801-538-6099, or by Internet E-mail at rmartin@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:

06/14/2006

This rule may become effective on:

06/22/2006

Authorized by:

Richard Melton, Deputy Director

RULE TEXT

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

R414-303. Coverage Groups.

R414-303-7. Foster Care and Independent Foster Care Adolescents.

(1) The Department adopts 42 CFR 435.115(e)(2), 2001 ed., which is incorporated by reference.

(2) Eligibility for foster children who meet the definition of a dependent child under the State Plan for Aid to Families with Dependent Children in effect on July 16, 1996, is not governed by this rule. The Department of Human Services determines eligibility for foster care Medicaid.

(3) The Department covers individuals who are 18 years old but not yet 21 years old as described in 1902(a)(10)(A)(ii)(XVII) of the Social Security Act. This coverage is the Independent Foster Care Adolescents program. The Department determines eligibility according to the following requirements.

(a) At the time the individual turns 18 years of age, the individual must be in the custody of the Division of Child and Family Services, or the Department of Human Services if the Division of Child and Family Services was the primary case manager, or a federally recognized Indian tribe, but not in the custody of the Division of Youth Corrections.

(b) Income and assets of the child are not counted to determine eligibility under the Independent Foster Care Adolescents program.

(c) Medicaid eligibility under this coverage group is not available for any month before July 1, 2006.

(d) When funds are available, an eligible independent foster care adolescent can receive Medicaid under this coverage group until he or she reaches 21 years of age, and through the end of that month.

KEY: income, coverage groups, independent foster care adolescent

Date of Enactment of Last Substantive Amendment: [October 16, 2004]2006

Notice of Continuation: January 31, 2003

Authorizing and Implemented or interpreted law: 26-18-3; 26-1-5

ADDITIONAL INFORMATION

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For questions regarding the content or application of this rule, please contact Ross Martin at the above address, by phone at 801-538-6592, by FAX at 801-538-6099, or by Internet E-mail at rmartin@utah.gov

For questions about the rulemaking process, please contact the Division of Administrative Rules (801-538-3764). Please Note: The Division of Administrative Rules is NOT able to answer questions about the content or application of these administrative rules.