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Utah Code Title 26B. Utah Health and Human Services Codes § 26B-3-222. Medicaid waiver expansion for extraordinary care reimbursement

Current as of January 01, 2025 | Updated by Findlaw Staff

(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) “Guardian” means a person appointed by a court to manage the affairs of a living individual.

(c) “Parent” means a biological parent, adoptive parent, or step-parent of an individual.

(d) “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)(d)(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.

(e) “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).

(5) Before July 1, 2023, 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 to whom the individual is a parent or guardian.

(6) If CMS approves the amendment described in Subsection (5), the department shall implement the program described in Subsection (5).

(7) The department shall by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, define “extraordinary care” for purposes of Subsection (5).

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Cite this article: FindLaw.com - Utah Code Title 26B. Utah Health and Human Services Codes § 26B-3-222. Medicaid waiver expansion for extraordinary care reimbursement - last updated January 01, 2025 | https://codes.findlaw.com/ut/title-26b-utah-health-and-human-services-codes/ut-code-sect-26b-3-222/

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