LegalFix

Section 16 - Medicaid -- Continuous eligibility -- Promoting payment and delivery reform.

UT Code § 26-18-16 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(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.

(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.

(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

(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).

LegalFix

Copyright ©2024 LegalFix. All rights reserved. LegalFix is not a law firm, is not licensed to practice law, and does not provide legal advice, services, or representation. The information on this website is an overview of the legal plans you can purchase—or that may be provided by your employer as an employee benefit or by your credit union or other membership group as a membership benefit.

LegalFix provides its members with easy access to affordable legal services through a network of independent law firms. LegalFix, its corporate entity, and its officers, directors, employees, agents, and contractors do not provide legal advice, services, or representation—directly or indirectly.

The articles and information on the site are not legal advice and should not be relied upon—they are for information purposes only. You should become a LegalFix member to get legal services from one of our network law firms.

You should not disclose confidential or potentially incriminating information to LegalFix—you should only communicate such information to your network law firm.

The benefits and legal services described in the LegalFix legal plans are not always available in all states or with all plans. See the legal plan Benefit Overview and the more comprehensive legal plan contract during checkout for coverage details in your state.

Use of this website, the purchase of legal plans, and access to the LegalFix networks of law firms are subject to the LegalFix Terms of Service and Privacy Policy.

We have updated our Terms of Service, Privacy Policy, and Disclosures. By continuing to browse this site, you agree to our Terms of Service, Privacy Policy, and Disclosures.
Section 16 - Medicaid -- Continuous eligibility -- Promoting payment and delivery reform.