reglab/housing_qa huggingface dataset:
UT Code § 26-18-7 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 7 - Medical vendor rates.

26-18-7. Medical vendor rates.  Medical vendor payments made to providers of services for and in behalf of recipient households shall be based upon predetermined rates from standards developed by the division in cooperation with providers of services for each type of service purchased by the division. As far as possible, the rates paid for services shall be established in advance of the fiscal year for which funds are to be requested.  Amended by Chapter 21, 1988 General Session
UT Code § 26-18-8 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 8 - Enforcement of public assistance statutes.

 Effective 5/12/2020  26-18-8. Enforcement of public assistance statutes.    (1) The department shall enforce or contract for the enforcement of Sections 35A-1-503, 35A-3-108, 35A-3-110, 35A-3-111, 35A-3-112, and 35A-3-603 to the extent that these sections pertain to benefits conferred or administered by the division under this chapter, to the extent allowed under federal law or regulation.     (2) The department may contract for services covered in Section 35A-3-111 insofar as that section pertains to benefits conferred or administered by the division under this chapter.    Amended by Chapter 225, 2020 General Session
UT Code § 26-18-9 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 9 - Prohibited acts of state or local employees of Medicaid program -- Violation a misdemeanor.

26-18-9. Prohibited acts of state or local employees of Medicaid program -- Violation a misdemeanor.  Each state or local employee responsible for the expenditure of funds under the state Medicaid program, each individual who formerly was such an officer or employee, and each partner of such an officer or employee is prohibited for a period of one year after termination of such responsibility from committing any act, the commission of which by an officer or employee of the United States Government, an individual who was such an officer or employee, or a partner of such an officer or employee is prohibited by Section 207 or Section 208 of Title 18, United States Code. Violation of this section is a class A misdemeanor.  Enacted by Chapter 126, 1981 General Session
UT Code § 26-18-11 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 11 - Rural hospitals.

 Effective 5/14/2019  26-18-11. Rural hospitals.    (1) For purposes of this section "rural hospital" means a hospital located outside of a standard metropolitan statistical area, as designated by the United States Bureau of the Census.     (2) For purposes of the Medicaid program, the Division of Medicaid and Health Financing may not discriminate among rural hospitals on the basis of size.    Amended by Chapter 393, 2019 General Session
UT Code § 26-18-13 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 13 - Telemedicine -- Reimbursement -- Rulemaking.

 Effective 5/9/2017  26-18-13. Telemedicine -- Reimbursement -- Rulemaking.    (1)   (a) As used in this section, communication by telemedicine is considered face-to-face contact between a health care provider and a patient under the state's medical assistance program if:   (i) the communication by telemedicine meets the requirements of administrative rules adopted in accordance with Subsection (3); and     (ii) the health care services are eligible for reimbursement under the state's medical assistance program.       (b) This Subsection (1) applies to any managed care organization that contracts with the state's medical assistance program.       (2) The reimbursement rate for telemedicine services approved under this section:   (a) shall be subject to reimbursement policies set by the state plan; and     (b) may be based on:   (i) a monthly reimbursement rate;     (ii) a daily reimbursement rate; or     (iii) an encounter rate.         (3) The department shall adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, which establish:   (a) the particular telemedicine services that are considered face-to-face encounters for reimbursement purposes under the state's medical assistance program; and     (b) the reimbursement methodology for the telemedicine services designated under Subsection (3)(a).      Amended by Chapter 241, 2017 General Session
UT Code § 26-18-13.5 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 13.5 - Telehealth services -- Reimbursement -- Reporting -- Telepsychiatric consultations.

 Effective 5/14/2019  26-18-13.5. Telehealth services -- Reimbursement -- Reporting -- Telepsychiatric consultations.    (1) As used in this section:   (a) "Telehealth services" means the same as that term is defined in Section 26-60-102.     (b) "Telemedicine services" means the same as that term is defined in Section 26-60-102.     (c) "Telepsychiatric consultation" means a consultation between a physician and a board certified psychiatrist, both of whom are licensed to engage in the practice of medicine in the state, that utilizes:   (i) the health records of the patient, provided from the patient or the referring physician;     (ii) a written, evidence-based patient questionnaire; and     (iii) telehealth services that meet industry security and privacy standards, including compliance with the:   (A) Health Insurance Portability and Accountability Act; and     (B) Health Information Technology for Economic and Clinical Health Act, Pub. L. No. 111-5, 123 Stat. 226, 467, as amended.           (2) This section applies to:   (a) a managed care organization that contracts with the Medicaid program; and     (b) a provider who is reimbursed for health care services under the Medicaid program.       (3) The Medicaid program shall reimburse for telemedicine services at the same rate that the Medicaid program reimburses for other health care services.     (4) The Medicaid program shall reimburse for telepsychiatric consultations at a rate set by the Medicaid program.    Amended by Chapter 249, 2019 General Session
UT Code § 26-18-15 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 15 - Process to promote health insurance coverage for children.

 Effective 5/5/2021  26-18-15. Process to promote health insurance coverage for children.    (1) The department, in collaboration with the Department of Workforce Services and the State Board of Education, shall develop a process to promote health insurance coverage for a child in school when:   (a) the child applies for free or reduced price school lunch;     (b) a child enrolls in or registers in school; and     (c) other appropriate school related opportunities.       (2) The department, in collaboration with the Department of Workforce Services, shall promote and facilitate the enrollment of children identified under Subsection (1) without health insurance in the Utah Children's Health Insurance Program, the Medicaid program, or the Utah Premium Partnership for Health Insurance Program.    Amended by Chapter 163, 2021 General Session
UT Code § 26-18-16 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 16 - Medicaid -- Continuous eligibility -- Promoting payment and delivery reform.

26-18-16. Medicaid -- Continuous eligibility -- Promoting payment and delivery reform.    (1) In accordance with Subsection (2), and within appropriations from the Legislature, the department may amend the state Medicaid plan to:   (a) create continuous eligibility for up to 12 months for an individual who has qualified for the state Medicaid program;     (b) provide incentives in managed care contracts for an individual to obtain appropriate care in appropriate settings; and     (c) require the managed care system to accept the risk of managing the Medicaid population assigned to the plan amendment in return for receiving the benefits of providing quality and cost effective care.       (2) If the department amends the state Medicaid plan under Subsection (1)(a) or (b), the department:   (a) shall ensure that the plan amendment:   (i) is cost effective for the state Medicaid program;     (ii) increases the quality and continuity of care for recipients; and     (iii) calculates and transfers administrative savings from continuous enrollment from the Department of Workforce Services to the Department of Health; and       (b) may limit the plan amendment under Subsection (1)(a) or (b) to select geographic areas or specific Medicaid populations.       (3) The department may seek approval for a state plan amendment, waiver, or a demonstration project from the Secretary of Health and Human Services if necessary to implement a plan amendment under Subsection (1)(a) or (b).    Enacted by Chapter 155, 2012 General Session
UT Code § 26-18-17 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 17 - Patient notice of health care provider privacy practices.

26-18-17. Patient notice of health care provider privacy practices.    (1)   (a) For purposes of this section:   (i) "Health care provider" means a health care provider as defined in Section 78B-3-403 who:   (A) receives payment for medical services from the Medicaid program established in this chapter, or the Children's Health Insurance Program established in Chapter 40, Utah Children's Health Insurance Act; and     (B) submits a patient's personally identifiable information to the Medicaid eligibility database or the Children's Health Insurance Program eligibility database.       (ii) "HIPAA" means 45 C.F.R. Parts 160, 162, and 164, Health Insurance Portability and Accountability Act of 1996, as amended.       (b) Beginning July 1, 2013, this section applies to the Medicaid program, the Children's Health Insurance Program created in Chapter 40, Utah Children's Health Insurance Act, and a health care provider.       (2) A health care provider shall, as part of the notice of privacy practices required by HIPAA, provide notice to the patient or the patient's personal representative that the health care provider either has, or may submit, personally identifiable information about the patient to the Medicaid eligibility database and the Children's Health Insurance Program eligibility database.     (3) The Medicaid program and the Children's Health Insurance Program may not give a health care provider access to the Medicaid eligibility database or the Children's Health Insurance Program eligibility database unless the health care provider's notice of privacy practices complies with Subsection (2).     (4) The department may adopt an administrative rule to establish uniform language for the state requirement regarding notice of privacy practices to patients required under Subsection (2).    Enacted by Chapter 53, 2013 General Session
UT Code § 26-18-18 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 18 - Optional Medicaid expansion.

 Effective 5/14/2019  26-18-18. Optional Medicaid expansion.    (1) The department and the governor may not expand the state's Medicaid program under PPACA unless:   (a) the department expands Medicaid in accordance with Section 26-18-415; or     (b)   (i) the governor or the governor's designee has reported the intention to expand the state Medicaid program under PPACA to the Legislature in compliance with the legislative review process in Section 26-18-3; and     (ii) the governor submits the request for expansion of the Medicaid program for optional populations to the Legislature under the high impact federal funds request process required by Section 63J-5-204.         (2)   (a) The department shall request approval from CMS for waivers from federal statutory and regulatory law necessary to implement the health coverage improvement program under Section 26-18-411.     (b) The health coverage improvement program under Section 26-18-411 is not subject to the requirements in Subsection (1).      Amended by Chapter 393, 2019 General Session
UT Code § 26-18-19 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 19 - Medicaid vision services -- Request for proposals.

 Effective 5/10/2016  26-18-19. Medicaid vision services -- Request for proposals.  The department may select one or more contractors, in accordance with Title 63G, Chapter 6a, Utah Procurement Code, to provide vision services to the Medicaid populations that are eligible for vision services, as described in department rules, without restricting provider participation, and within existing appropriations from the Legislature. Amended by Chapter 114, 2016 General Session
UT Code § 26-18-22 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 22 - Screening, Brief Intervention, and Referral to Treatment Medicaid reimbursement.

 Effective 5/9/2017  26-18-22. Screening, Brief Intervention, and Referral to Treatment Medicaid reimbursement.    (1) As used in this section:   (a) "Controlled substance prescriber" means a controlled substance prescriber, as that term is defined in Section 58-37-6.5, who:   (i) has a record of having completed SBIRT training, in accordance with Subsection 58-37-6.5(2), before providing the SBIRT services; and     (ii) is a Medicaid enrolled health care provider.       (b) "SBIRT" means the same as that term is defined in Section 58-37-6.5.       (2) The department shall reimburse a controlled substance prescriber who provides SBIRT services to a Medicaid enrollee who is 13 years of age or older for the SBIRT services.    Enacted by Chapter 180, 2017 General Session  Technically renumbered to avoid duplication of section number also enacted in HB194, Chapter 247.
UT Code § 26-18-23 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 23 - Prescribing policies for opioid prescriptions.

 Effective 5/9/2017  26-18-23. Prescribing policies for opioid prescriptions.    (1) The department may implement a prescribing policy for certain opioid prescriptions that is substantially similar to the prescribing policies required in Section 31A-22-615.5.     (2) The department may amend the state program and apply for waivers for the state program, if necessary, to implement Subsection (1).    Enacted by Chapter 53, 2017 General Session  Technically renumbered to avoid duplication of section number also enacted in HB194, Chapter 247.
UT Code § 26-18-24 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 24 - Reimbursement for long-acting reversible contraception immediately following childbirth.

 Effective 5/8/2018  26-18-24. Reimbursement for long-acting reversible contraception immediately following childbirth.    (1) As used in this section, "long-acting reversible contraception" means a contraception method that requires administration less than once per month, including:   (a) an intrauterine device; and     (b) a contraceptive implant.       (2) The division shall separately identify and reimburse, from other labor and delivery services within the Medicaid program, the provision and insertion of long-acting reversible contraception immediately after childbirth.    Enacted by Chapter 180, 2018 General Session
UT Code § 26-18-25 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 25 - Coverage of exome sequence testing.

 Effective 5/14/2019  26-18-25. Coverage of exome sequence testing.    (1) As used in this section, "exome sequence testing" means a genomic technique for sequencing the genome of an individual for diagnostic purposes.     (2) The Medicaid program shall reimburse for exome sequence testing:   (a) for an enrollee who:   (i) is younger than 21 years of age; and     (ii) who remains undiagnosed after exhausting all other appropriate diagnostic-related tests;       (b) performed by a nationally recognized provider with significant experience in exome sequence testing;     (c) that is medically necessary; and     (d) at a rate set by the Medicaid program.      Enacted by Chapter 320, 2019 General Session
UT Code § 26-18-26 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 26 - Reimbursement for nonemergency secured behavioral health transport providers.

 Effective 5/14/2019  26-18-26. Reimbursement for nonemergency secured behavioral health transport providers.  The department may not reimburse a nonemergency secured behavioral health transport provider that is designated under Section 26-8a-303. Enacted by Chapter 265, 2019 General Session  Technically renumbered to avoid duplication of section number used in HB 435, Chapter 320.
UT Code § 26-18-27 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 1 - Medical Assistance Programs|Section 27 - Children's Health Care Coverage Program.

 Affected by 63I-1-226 on 7/1/2025  Effective 5/5/2021  26-18-27. Children's Health Care Coverage Program.    (1) As used in this section:   (a) "CHIP" means the Children's Health Insurance Program created in Section 26-40-103.     (b) "Program" means the Children's Health Care Coverage Program created in Subsection (2).       (2)   (a) There is created the Children's Health Care Coverage Program within the department.     (b) The purpose of the program is to:   (i) promote health insurance coverage for children in accordance with Section 26-18-15;     (ii) conduct research regarding families who are eligible for Medicaid and CHIP to determine awareness and understanding of available coverage;     (iii) analyze trends in disenrollment and identify reasons that families may not be renewing enrollment, including any barriers in the process of renewing enrollment;     (iv) administer surveys to recently enrolled CHIP and children's Medicaid enrollees to identify:   (A) how the enrollees learned about coverage; and     (B) any barriers during the application process;       (v) develop promotional material regarding CHIP and children's Medicaid eligibility, including outreach through social media, video production, and other media platforms;     (vi) identify ways that the eligibility website for enrollment in CHIP and children's Medicaid can be redesigned to increase accessibility and enhance the user experience;     (vii) identify outreach opportunities, including partnerships with community organizations including:   (A) schools;     (B) small businesses;     (C) unemployment centers;     (D) parent-teacher associations; and     (E) youth athlete clubs and associations; and       (viii) develop messaging to increase awareness of coverage options that are available through the department.         (3)   (a) The department may not delegate implementation of the program to a private entity.     (b) Notwithstanding Subsection (3)(a), the department may contract with a media agency to conduct the activities described in Subsection (2)(b)(iv) and (vii).      Enacted by Chapter 163, 2021 General Session
UT Code § 26-18-102 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 2 - Drug Utilization Review Board|Section 102 - DUR Board -- Creation and membership -- Expenses.

 Affected by 63I-1-226 on 7/1/2027 26-18-102. DUR Board -- Creation and membership -- Expenses.    (1) There is created a 12-member Drug Utilization Review Board responsible for implementation of a retrospective and prospective DUR program.     (2)   (a) Except as required by Subsection (2)(b), as terms of current board members expire, the executive director shall appoint each new member or reappointed member to a four-year term.     (b) Notwithstanding the requirements of Subsection (2)(a), the executive director shall, at the time of appointment or reappointment, adjust the length of terms to ensure that the terms of board members are staggered so that approximately half of the board is appointed every two years.     (c) Persons appointed to the board may be reappointed upon completion of their terms, but may not serve more than two consecutive terms.     (d) The executive director shall provide for geographic balance in representation on the board.       (3) When a vacancy occurs in the membership for any reason, the replacement shall be appointed for the unexpired term.     (4) The membership shall be comprised of the following:   (a) four physicians who are actively engaged in the practice of medicine or osteopathic medicine in this state, to be selected from a list of nominees provided by the Utah Medical Association;     (b) one physician in this state who is actively engaged in academic medicine;     (c) three pharmacists who are actively practicing in retail pharmacy in this state, to be selected from a list of nominees provided by the Utah Pharmaceutical Association;     (d) one pharmacist who is actively engaged in academic pharmacy;     (e) one person who shall represent consumers;     (f) one person who shall represent pharmaceutical manufacturers, to be recommended by the Pharmaceutical Manufacturers Association; and     (g) one dentist licensed to practice in this state under Title 58, Chapter 69, Dentist and Dental Hygienist Practice Act, who is actively engaged in the practice of dentistry, nominated by the Utah Dental Association.       (5) Physician and pharmacist members of the board shall have expertise in clinically appropriate prescribing and dispensing of outpatient drugs.     (6) The board shall elect a chair from among its members who shall serve a one-year term, and may serve consecutive terms.     (7) A member may not receive compensation or benefits for the member's service, but may receive per diem and travel expenses in accordance with:   (a) Section 63A-3-106;     (b) Section 63A-3-107; and     (c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and 63A-3-107.      Amended by Chapter 286, 2010 General SessionAmended by Chapter 324, 2010 General Session
UT Code § 26-18-104 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 2 - Drug Utilization Review Board|Section 104 - Confidentiality of records.

 Affected by 63I-1-226 on 7/1/2027 26-18-104. Confidentiality of records.    (1) Information obtained under this part shall be treated as confidential or controlled information under Title 63G, Chapter 2, Government Records Access and Management Act.     (2) The board shall establish procedures insuring that the information described in Subsection 26-18-103(16) is held confidential by the pharmacist, being provided to the physician only upon request.     (3) The board shall adopt and implement procedures designed to ensure the confidentiality of all information collected, stored, retrieved, assessed, or analyzed by the board, staff to the board, or contractors to the DUR program, that identifies individual physicians, pharmacists, or recipients. The board may have access to identifying information for purposes of carrying out intervention activities, but that identifying information may not be released to anyone other than a member of the board. The board may release cumulative nonidentifying information for research purposes.    Amended by Chapter 382, 2008 General Session