DAR File No. 29966

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-100

Medicaid Primary Care Network Services

FIVE-YEAR NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

DAR File No.: 29966
Filed: 05/24/2007, 11:49
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 26-18-3 establishes the Department as the single state agency responsible for the administration of the Medicaid program in connection with the United States Department of Health and Human Services pursuant to Title XIX of the Social Security Act. Section 26-18-3 also requires the Department to enact administrative rules to implement Medicaid programs. Section 1115 of the Social Security Act authorizes the Division to establish waiver programs to provide services not otherwise available to Medicaid clients. The Primary Care Network (PCN) Services program is a waiver program allowed under Section 1115 of the Social Security Act, which the Department implements under these statutes.

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

Written comments from PCN clients indicate that they wish PCN services to continue.

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 specifies the services available under the PCN. This rule also details the cost sharing provisions for PCN clients. Therefore, this rule should be continued.

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:

Melissa Frost at the above address, by phone at 801-538-6381, by FAX at 801-538-6099, or by Internet E-mail at mlfrost@utah.gov

Authorized by:

David N. Sundwall, Executive Director