reglab/housing_qa huggingface dataset:
UT Code § 26-18-420 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 420 - Coverage for in vitro fertilization and genetic testing.

 Affected by 63I-2-226 on 7/1/2030  Effective 5/12/2020  26-18-420. Coverage for in vitro fertilization and genetic testing.    (1) As used in this section:   (a) "Qualified condition" means:   (i) cystic fibrosis;     (ii) spinal muscular atrophy;     (iii) Morquio Syndrome;     (iv) myotonic dystrophy; or     (v) sickle cell anemia.       (b) "Qualified enrollee" means an individual who:   (i) is enrolled in the Medicaid program;     (ii) has been diagnosed by a physician as having a genetic trait associated with a qualified condition; and     (iii) intends to get pregnant with a partner who is diagnosed by a physician as having a genetic trait associated with the same qualified condition as the individual.         (2) Before January 1, 2021, the department shall apply for a Medicaid waiver or a state plan amendment with the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services to implement the coverage described in Subsection (3).     (3) If the waiver described in Subsection (2) is approved, the Medicaid program shall provide coverage to a qualified enrollee for:   (a) in vitro fertilization services; and     (b) genetic testing of a qualified enrollee who receives in vitro fertilization services under Subsection (3)(a).       (4) The Medicaid program may not provide the coverage described in Subsection (3) before the later of:   (a) the day on which the waiver described in Subsection (2) is approved; and     (b) January 1, 2021.       (5) Before November 1, 2022, and before November 1 of every third year thereafter, the department shall:   (a) calculate the change in state spending attributable to the coverage under this section; and     (b) report the amount described in Subsection (4)(a) to the Health and Human Services Interim Committee and the Social Services Appropriations Subcommittee.      Enacted by Chapter 187, 2020 General Session
UT Code § 26-18-420.1 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 420.1 - Medicaid waiver for fertility preservation services.

 Effective 5/5/2021  26-18-420.1. Medicaid waiver for fertility preservation services.    (1) As used in this section:   (a) "Iatrogenic infertility" means an impairment of fertility or reproductive functioning caused by surgery, chemotherapy, radiation, or other medical treatment.     (b) "Physician" means an individual licensed to practice under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act.     (c) "Qualified enrollee" means an individual who:   (i) is enrolled in the Medicaid program;     (ii) has been diagnosed with a form of cancer by a physician; and     (iii) needs treatment for that cancer that may cause a substantial risk of sterility or iatrogenic infertility, including surgery, radiation, or chemotherapy.       (d) "Standard fertility preservation service" means a fertility preservation procedure and service that:   (i) is not considered experimental or investigational by the American Society for Reproductive Medicine or the American Society of Clinical Oncology; and     (ii) is consistent with established medical practices or professional guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, including:   (A) sperm banking;     (B) oocyte banking;     (C) embryo banking;     (D) banking of reproductive tissues; and     (E) storage of reproductive cells and tissues.           (2) Before January 1, 2022, the department shall apply for a Medicaid waiver or a state plan amendment with CMS to implement the coverage described in Subsection (3).     (3) If the waiver or state plan amendment described in Subsection (2) is approved, the Medicaid program shall provide coverage to a qualified enrollee for standard fertility preservation services.     (4) The Medicaid program may not provide the coverage described in Subsection (3)  before the later of:   (a) the day on which the waiver described in Subsection (2) is approved; and     (b) January 1, 2023.       (5) Before November 1, 2023, and before November 1 of each third year after 2023, the department shall:   (a) calculate the change in state spending attributable to the coverage described in this section; and     (b) report the amount described in Subsection (5)(a) to the Health and Human Services Interim Committee and the Social Services Appropriations Subcommittee.      Enacted by Chapter 133, 2021 General Session
UT Code § 26-18-421 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 421 - Medicaid waiver for coverage of qualified inmates leaving prison or jail.

 Effective 5/12/2020  26-18-421. Medicaid waiver for coverage of qualified inmates leaving prison or jail.    (1) As used in this section:   (a) "Correctional facility" means:   (i) a county jail;     (ii) the Department of Corrections, created in Section 64-13-2; or     (iii) a prison, penitentiary, or other institution operated by or under contract with the Department of Corrections for the confinement of an offender, as defined in Section 64-13-1.       (b) "Qualified inmate" means an individual who:   (i) is incarcerated in a correctional facility; and     (ii) has:   (A) a chronic physical or behavioral health condition;     (B) a mental illness, as defined in Section 62A-15-602; or     (C) an opioid use disorder.           (2) Before July 1, 2020, the division shall apply for a Medicaid waiver or a state plan amendment with CMS to offer a program to provide Medicaid coverage to a qualified inmate for up to 30 days immediately before the day on which the qualified inmate is released from a correctional facility.     (3) If the waiver or state plan amendment described in Subsection (2) is approved, the department shall report to the Health and Human Services Interim Committee each year before November 30 while the waiver or state plan amendment is in effect regarding:   (a) the number of qualified inmates served under the program;     (b) the cost of the program; and     (c) the effectiveness of the program, including:   (i) any reduction in the number of emergency room visits or hospitalizations by inmates after release from a correctional facility;     (ii) any reduction in the number of inmates undergoing inpatient treatment after release from a correctional facility;     (iii) any reduction in overdose rates and deaths of inmates after release from a correctional facility; and     (iv) any other costs or benefits as a result of the program.         (4) If the waiver or state plan amendment described in Subsection (2) is approved, a county that is responsible for the cost of a qualified inmate's medical care shall provide the required matching funds to the state for:   (a) any costs to enroll the qualified inmate for the Medicaid coverage described in Subsection (2);     (b) any administrative fees for the Medicaid coverage described in Subsection (2); and     (c) the Medicaid coverage that is provided to the qualified inmate under Subsection (2).      Enacted by Chapter 159, 2020 General Session  Technically renumbered to avoid duplication of section number also enacted in HB214, Chapter 187, HB219, Chapter 188, and HB32, Chapter 303.
UT Code § 26-18-422 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 422 - Medicaid waiver for inpatient care in an institution for mental diseases.

 Effective 5/12/2020  26-18-422. Medicaid waiver for inpatient care in an institution for mental diseases.    (1) As used in this section, "institution for mental diseases" means the same as that term is defined in 42 C.F.R. Sec. 435.1010.     (2) Before August 1, 2020, the division shall apply for a Medicaid waiver or a state plan amendment with CMS to offer a program that provides reimbursement for mental health services that are provided:   (a) in an institution for mental diseases that includes more than 16 beds; and     (b) to an individual who receives mental health services in an institution for mental diseases for a period of more than 15 days in a calendar month.       (3) If the waiver or state plan amendment described in Subsection (2) is approved, the department shall:   (a) coordinate with the Department of Human Services to develop and offer the program described in Subsection (2); and     (b) submit to the Health and Human Services Interim Committee and the Social Services Appropriations Subcommittee any report that the department submits to CMS that relates to the budget neutrality, independent waiver evaluation, or performance metrics of the program described in Subsection (2), within 15 days after the day on which the report is submitted to CMS.       (4) Notwithstanding Sections 17-43-201 and 17-43-301, if the waiver or state plan amendment described in Subsection (2) is approved, a county does not have to provide matching funds to the state for the mental health services described in Subsection (2) that are provided to an individual who qualifies for Medicaid coverage under Section 26-18-3.9 or Section 26-18-411.    Enacted by Chapter 188, 2020 General Session  Technically renumbered to avoid duplication of section number also enacted in HB214, Chapter 187, HB38, Chapter 159, and HB32, Chapter 303.
UT Code § 26-18-423 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 423 - Reimbursement for crisis management services provided in a behavioral health receiving center -- Integration of payment for physical health services.

 Effective 5/12/2020  26-18-423. Reimbursement for crisis management services provided in a behavioral health receiving center -- Integration of payment for physical health services.    (1) As used in this section:   (a) "Accountable care organization" means the same as that term is defined in Section 26-18-408.     (b) "Behavioral health receiving center" means the same as that term is defined in Section 62A-15-118.     (c) "Crisis management services" means behavioral health services provided to an individual who is experiencing a mental health crisis.     (d) "Managed care organization" means the same as that term is defined in 42 C.F.R. Sec. 438.2.       (2) Before July 1, 2020, the division shall apply for a Medicaid waiver or state plan amendment with CMS to offer a program that provides reimbursement through a bundled daily rate for crisis management services that are delivered to an individual during the individual's stay at a behavioral health receiving center.     (3) If the waiver or state plan amendment described in Subsection (2) is approved, the department shall:   (a) implement the program described in Subsection (2); and     (b) require a managed care organization that contracts with the state's Medicaid program for behavioral health services or integrated health services to provide coverage for crisis management services that are delivered to an individual during the individual's stay at a behavioral health receiving center.       (4)   (a) The department may elect to integrate payment for physical health services provided in a behavioral health receiving center.     (b) In determining whether to integrate payment under Subsection (4)(a), the department shall consult with accountable care organizations and counties in the state.      Enacted by Chapter 303, 2020 General Session  Technically renumbered to avoid duplication of section number also enacted in HB214, Chapter 187, HB38, Chapter 159, and HB219, Chapter 188.
UT Code § 26-18-424 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 424 - Crisis services -- Reimbursement.

 Effective 3/11/2021  26-18-424. Crisis services -- Reimbursement.  The Department shall submit a waiver or state plan amendment to allow for reimbursement for 988 services provided to an individual who is eligible and enrolled in Medicaid at the time this service is provided. Enacted by Chapter 76, 2021 General Session
UT Code § 26-18-425 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 425 - Medicaid waiver for respite care facility that provides services to homeless individuals.

 Effective 5/5/2021  26-18-425. Medicaid waiver for respite care facility that provides services to homeless individuals.    (1) As used in this section:   (a) "Adult in the expansion population" means an adult:   (i) described in 42 U.S.C. Sec. 1396a(a)(10)(A)(i)(VIII); and     (ii) not otherwise eligible for Medicaid as a mandatory categorically needy individual.       (b) "Homeless" means the same as that term is defined in Section 26-18-411.     (c) "Medical respite care" means short-term housing with supportive medical services.     (d) "Medical respite facility" means a residential facility that provides medical respite care to homeless individuals.       (2) Before January 1, 2022, the department shall apply for a Medicaid waiver or state plan amendment with CMS to choose a single medical respite facility to reimburse for services provided to an individual who is:   (a) homeless; and     (b) an adult in the expansion population.       (3) The department shall choose a medical respite facility best able to serve homeless individuals who are adults in the expansion population.     (4) If the waiver or state plan amendment described in Subsection (2) is approved, while the waiver or state plan amendment is in effect, the department shall submit a report to the Health and Human Services Interim Committee each year before November 30 detailing:   (a) the number of homeless individuals served at the facility;     (b) the cost of the program; and     (c) the reduction of health care costs due to the program's implementation.       (5) Through administrative rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the department shall further define and limit the services, described in this section, provided to a homeless individual.    Enacted by Chapter 27, 2021 General Session  Technically renumbered to avoid duplication of section number also enacted in SB155, Chapter 76, and SB63, Chapter 212.
UT Code § 26-18-426 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 4 - Medicaid Waiver|Section 426 - Medicaid waiver expansion for extraordinary care reimbursement.

 Effective 5/5/2021  26-18-426. Medicaid waiver expansion for extraordinary care reimbursement.    (1) As used in this section:   (a) "Existing home and community-based services waiver" means an existing home and community-based services waiver in the state that serves an individual:   (i) with an acquired brain injury;     (ii) with an intellectual or physical disability; or     (iii) who is 65 years old or older.       (b) "Personal care services" means a service that:   (i) is furnished to an individual who is not an inpatient nor a resident of a hospital, nursing facility, intermediate care facility, or institution for mental diseases;     (ii) is authorized for an individual described in Subsection (1)(b)(i) in accordance with a plan of treatment;     (iii) is provided by an individual who is qualified to provide the services; and     (iv) is furnished in a home or another community-based setting.       (c) "Waiver enrollee" means an individual who is enrolled in an existing home and community-based services waiver.       (2) Before July 1, 2021, the department shall apply with CMS for an amendment to an existing home and community-based services waiver to implement a program to offer reimbursement to an individual who provides personal care services that constitute extraordinary care to a waiver enrollee who is the individual's spouse.     (3) If CMS approves the amendment described in Subsection (2), the department shall implement the program described in Subsection (2).     (4) The department shall by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, define "extraordinary care" for purposes of Subsection (2).    Enacted by Chapter 212, 2021 General Session  Technically renumbered to avoid duplication of section number also enacted in SB155, Chapter 76, and HB34, Chapter 27.
UT Code § 26-18-501 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 5 - Long Term Care Facility - Medicaid Certification|Section 501 - Definitions.

 Effective 5/14/2019  26-18-501. Definitions.  As used in this part:  (1) "Certified program" means a nursing care facility program with Medicaid certification.     (2) "Director" means the state Medicaid director appointed under Section 26-18-2.2.     (3) "Medicaid certification" means the right of a nursing care facility, as a provider of a nursing care facility program, to receive Medicaid reimbursement for a specified number of beds within the facility.     (4)   (a) "Nursing care facility" means the following facilities licensed by the department under Chapter 21, Health Care Facility Licensing and Inspection Act:   (i) skilled nursing facilities;     (ii) intermediate care facilities; and     (iii) an intermediate care facility for people with an intellectual disability.       (b) "Nursing care facility" does not mean a critical access hospital that meets the criteria of 42 U.S.C. 1395i-4(c)(2) (1998).       (5) "Nursing care facility program" means the personnel, licenses, services, contracts and all other requirements that shall be met for a nursing care facility to be eligible for Medicaid certification under this part and division rule.     (6) "Physical facility" means the buildings or other physical structures where a nursing care facility program is operated.     (7) "Rural county" means a county with a population of less than 50,000, as determined by:   (a) the most recent official census or census estimate of the United States Bureau of the Census; or     (b) the most recent population estimate for the county from the Utah Population Committee, if a population figure for the county is not available under Subsection (7)(a).       (8) "Service area" means the boundaries of the distinct geographic area served by a certified program as determined by the division in accordance with this part and division rule.     (9) "Urban county" means a county that is not a rural county.    Amended by Chapter 393, 2019 General Session
UT Code § 26-18-502 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 5 - Long Term Care Facility - Medicaid Certification|Section 502 - Purpose -- Medicaid certification of nursing care facilities.

 Effective 5/5/2021  26-18-502. Purpose -- Medicaid certification of nursing care facilities.    (1) The Legislature finds:   (a) that an oversupply of nursing care facilities in the state adversely affects the state Medicaid program and the health of the people in the state;     (b) it is in the best interest of the state to prohibit nursing care facilities from receiving Medicaid certification, except as provided by this part; and     (c) it is in the best interest of the state to encourage aging nursing care facilities with Medicaid certification to renovate the nursing care facilities' physical facilities so that the quality of life and clinical services for Medicaid residents are preserved.       (2) Medicaid reimbursement of nursing care facility programs is limited to:   (a) the number of nursing care facility programs with Medicaid certification as of May 9, 2016; and     (b) additional nursing care facility programs approved for Medicaid certification under the provisions of Subsections 26-18-503(5) and (7).       (3) The division may not:   (a) except as authorized by Section 26-18-503:   (i) process initial applications for Medicaid certification or execute provider agreements with nursing care facility programs; or     (ii) reinstate Medicaid certification for a nursing care facility whose certification expired or was terminated by action of the federal or state government; or       (b) execute a Medicaid provider agreement with a certified program that moves to a different physical facility, except as authorized by Subsection 26-18-503(3).       (4) Notwithstanding Section 26-18-503, beginning May 4, 2021, the division may not approve a new or additional bed in an intermediate care facility for individuals with an intellectual disability for Medicaid certification, unless certification of the bed by the division does not increase the total number in the state of Medicaid-certified beds in intermediate care facilities for individuals with an intellectual disability.    Amended by Chapter 274, 2021 General Session
UT Code § 26-18-504 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 5 - Long Term Care Facility - Medicaid Certification|Section 504 - Appeals of division decision -- Rulemaking authority -- Application of act.

 Effective 7/1/2017  26-18-504. Appeals of division decision -- Rulemaking authority -- Application of act.    (1) A decision by the director under this part to deny Medicaid certification for a nursing care facility program or to deny additional bed capacity for an existing certified program is subject to review under the procedures and requirements of Title 63G, Chapter 4, Administrative Procedures Act.     (2) The department shall make rules to administer and enforce this part in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.     (3)   (a) In the event the department is at risk for a federal disallowance with regard to a Medicaid recipient being served in a nursing care facility program that is not Medicaid certified, the department may grant temporary Medicaid certification to that facility for up to 24 months.     (b)   (i) The department may extend a temporary Medicaid certification granted to a facility under Subsection (3)(a):   (A) for the number of beds in the nursing care facility occupied by a Medicaid recipient; and     (B) for the period of time during which the Medicaid recipient resides at the facility.       (ii) A temporary Medicaid certification granted under this Subsection (3) is revoked upon:   (A) the discharge of the patient from the facility; or     (B) the patient no longer residing at the facility for any reason.         (c) The department may place conditions on the temporary certification granted under Subsections (3)(a) and (b), such as:   (i) not allowing additional admissions of Medicaid recipients to the program; and     (ii) not paying for the care of the patient after October 1, 2008, with state only dollars.        Amended by Chapter 443, 2017 General Session
UT Code § 26-18-601 (2021)
2021 Utah Code|Title 26 - Utah Health Code|Chapter 18 - Medical Assistance Act|Part 6 - Medical Assistance Accountability|Section 601 - Title.

26-18-601. Title.  This part is known as "Medical Assistance Accountability."  Enacted by Chapter 362, 2011 General Session