DAR File No. 42936

Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-61-2

Incorporation by Reference

Notice of Proposed Rule

(Amendment)

DAR File No.: 42936
Filed: 05/25/2018 10:46:43 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to incorporate by reference updates to the Waiver for Technology Dependent/Medically Fragile Individuals, effective 07/01/2018.

Summary of the rule or change:

This renewal incorporates by reference updates to the Waiver for Technology Dependent/Medically Fragile Individuals, effective 07/01/2018. These updates include: the addition of High-flow Nasal Cannula dependence as an equivalent therapy to Bi-level Positive Airway Pressure and Continuous Positive Airway Pressure dependence as a qualifying technology to meet target group criteria; Removal of Family-Directed Support as a distinct service as this support will be provided through the scope of Financial Management Services and Waiver Case Management; and quality improvement performance measures were revised to better align with waiver assurances and sub-assurances.

Statutory or constitutional authorization for this rule:

• Section 26-1-5
• Section 26-18-3

This rule or change incorporates by reference the following material:

• Updates Waiver for Technology Dependent/Medically Fragile Individuals, published by Centers for Medicare & Medicaid Services, 07/01/2018

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because these waiver updates do not provide new services, and ongoing services are within previous allocations.

local governments:

There is no impact to local governments because they neither fund nor provide waiver services for Medicaid recipients.

small businesses:

There is no impact to small businesses because these waiver updates do not provide new services, and ongoing services are within previous allocations.

persons other than small businesses, businesses, or local governmental entities:

There is no impact to Medicaid providers or to Medicaid recipients because these waiver updates do not provide new services, and ongoing services are within previous allocations.

Compliance costs for affected persons:

There are no compliance costs to a single Medicaid provider or to a Medicaid recipient because these waiver updates do not provide new services, and ongoing services are within previous allocations.

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

After conducting a thorough analysis, it was determined that this proposed rule change will not result in a fiscal impact to businesses.

Joseph K. Miner, MD, Executive Director

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

07/16/2018

This rule may become effective on:

07/23/2018

Authorized by:

Joseph Miner, Executive Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2019	FY 2020	FY 2021
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$0	$0	$0
Net Fiscal Benefits:	$0	$0	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described in the narrative. Inestimable impacts for Non - Small Businesses are described in Appendix 2.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

There are neither costs nor revenue to the 182 Medicaid home and community-based service providers, as these waiver updates do not provide new services, and ongoing services are within previous allocations.

The Executive Director of the Department of Health, Joseph K. Miner, MD, has reviewed and approved this fiscal analysis.

 

 

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

R414-61. Home and Community-Based Services Waivers.

R414-61-2. Incorporation by Reference.

The Department incorporates by reference the following home and community-based services waivers:

(1) Waiver for Technology Dependent/Medically Fragile Individuals, effective July 1, 201[3]8;

(2) Waiver for Individuals Age 65 or Older, effective July 1, 2015;

(3) Waiver for Individuals with Acquired Brain Injuries, effective July 1, 2014;

(4) Waiver for Individuals with Physical Disabilities, effective July 1, 2016;

(5) Community Supports Waiver for Individuals with Intellectual Disabilities and Other Related Conditions, effective July 1, 2015;

(6) New Choices Waiver, effective July 1, 2015;

(7) Medicaid Autism Waiver, effective October 1, 2015; and

(8) Medically Complex Children's Waiver, effective October 1, 2015.

These documents are available for public inspection during business hours at the Utah Department of Health, Division of Medicaid and Health Financing, located at 288 North 1460 West, Salt Lake City, UT, 84114-3102.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [April 20, 2017]2018

Notice of Continuation: October 30, 2014

Authorizing, and Implemented or Interpreted Law: 26-18-3