DAR File No. 32619

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-21-2

Eligibility Requirements

NOTICE OF PROPOSED RULE

DAR File No.: 32619
Filed: 04/30/2009, 04:18
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to reinstate physical therapy and occupational therapy services to eligible adult Medicaid clients.

Summary of the rule or change:

This change reinstates physical therapy and occupational therapy services to eligible adult Medicaid clients.

State statutory or constitutional authorization for this rule:

Section 26-18-3

Anticipated cost or savings to:

the state budget:

The Department estimates an annual cost of $76,000 to the General Fund and $185,600 in federal dollars as a result of this change

local governments:

This change does not impact local governments because they do not fund or provide physical and occupational therapy to Medicaid clients.

small businesses and persons other than businesses:

Providers of physical therapy and occupational therapy will see a combined increase in annual revenue of $261,600 as a result of this change. The total savings to Medicaid clients is difficult to estimate because it is impossible to know how many clients would elect to obtain these services.

Compliance costs for affected persons:

The annual increase in revenue to a single provider of physical therapy is approximately $774, while the annual increase in revenue to a single provider of occupational therapy is approximately $1,480. These estimates are based on the total number of providers and client visits per year. The total savings to Medicaid clients is difficult to estimate because it is impossible to know how many clients would elect to obtain these services.

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

Appropriations from the 2009 Legislature allowed reinstatement of these services. David N. Sundwall, MD, 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:

Kimi McNutt at the above address, by phone at 801-538-6381, by FAX at 801-538-6099, or by Internet E-mail at KMCNUTT@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:

06/15/2009

Interested persons may attend a public hearing regarding this rule:

5/26/2009 at 1:00 PM, Utah Department of Health, Cannon Health Building, Room 114

This rule may become effective on:

07/01/2009

Authorized by:

David N. Sundwall, Executive Director

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

R414-21. Physical and Occupational Therapy.

R414-21-2. Eligibility Requirements.

Physical therapy and occupational therapy services are available [only ]to [clients who are pregnant women or who are individuals eligible under the Early and Periodic Screening, Diagnosis and Treatment Program. In addition, physical therapy and occupational therapy services are available to a client as a component of inpatient or outpatient hospital services]categorically and medically needy individuals under Medicaid when received from an independent occupational therapist or an independent physical therapist including group practices, rehabilitation centers, and hospitals.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [February 24], 2009

Notice of Continuation: April 16, 2007

Authorizing, and Implemented or Interpreted Law: 26-1-4.1; 26-1-5; 26-18-3