DAR File No. 31493

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-6

Reduction in Certain Targeted Case Management Services

NOTICE OF PROPOSED RULE

DAR File No.: 31493
Filed: 05/28/2008, 10:02
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to update which targeted case management (TCM) programs are not available to Medicaid recipients.

Summary of the rule or change:

This amendment removes the exclusion of TCM services for the homeless because these services are available to eligible Medicaid recipients.

State statutory or constitutional authorization for this rule:

Sections 26-18-2.3 and 26-18-3

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because this change only implements current TCM policy into rule.

local governments:

There is no budget impact because local governments do not fund TCM services and they are not Medicaid providers.

small businesses and persons other than businesses:

There is no impact to other persons and small businesses because this change only implements current TCM policy into rule.

Compliance costs for affected persons:

There are no compliance costs because this change only implements current TCM policy into rule.

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

This rule change reflects current policy in Medicaid. Targeted case management services are available to Medicaid recipients including those without an established residence. No negative fiscal impact for business is expected. 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:

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:

07/15/2008

This rule may become effective on:

07/22/2008

Authorized by:

Richard Melton, Deputy Director

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

R414-6. Reduction in Certain Targeted Case Management Services.

R414-6-1. Introduction and Authority.

This rule describes the Utah Medicaid Program's reduction in certain targeted case management services. Utilization of cost-containment methods is authorized by [Title 26, Chapter 18, Section 2.3, UCA]Section 26-18-2.3.

 

R414-6-2. Definition.

"Targeted Case Management Services" are a set of planning, coordinating and monitoring activities that assist Medicaid recipients in the target group to access needed housing, employment, medical, nutritional, social, education, and other services to promote independent living and functioning in the community.

 

[R414-6-3. Targeted Case Management Services for Homeless Recipients.

Upon the effective date of this rule, targeted case management services for homeless recipients are not available.

 

]R414-6-[4]3. Targeted Case Management Services for Recipients with HIV/AIDS.

Upon the effective date of this rule, targeted case management services for recipients with HIV/AIDS are not available.

 

R414-6-[5]4. Targeted Case Management Services for Recipients Exposed to Tuberculosis.

Upon the effective date of this rule, targeted case management services for recipients exposed to tuberculosis are not available.

 

KEY: Medicaid, case management

Date of Enactment or Last Substantive Amendment: [May 13, 2003]2008

Notice of Continuation: April 21, 2008

Authorizing, and Implemented or Interpreted Law: 26-18