DAR File No. 29493

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-10A

Transplant Services Standards

FIVE-YEAR NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

DAR File No.: 29493
Filed: 02/02/2007, 04:29
Received by: NL

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 26-1-5 grants the Department of Health the power to adopt, amend, or rescind rules that shall have the force and effect of law. Section 26-18-3 requires the Department to administer the Medicaid program. 42 CFR 440, Subpart A, authorizes inpatient hospital services.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

Some transplant service providers have requested less restrictive criteria to increase transplant services for Medicaid clients. Still, others in the health care community emphasize that the criteria's survival rates support the transplant restrictions.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule is necessary because it implements tissue and organ transplantation criteria for Medicaid clients. Therefore, this rule should be continued. Medicaid disagrees with comments to ease transplant restrictions because survival rates indicate that less restriction increases the risk of patient death, provides only limited clinical benefit, and significantly increases transplant costs.

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

Authorized by:

David N. Sundwall, Executive Director