H.B. 174 Enrolled

1

CONTRACTING FOR MEDICAID ELIGIBILITY
2 DETERMINATION SERVICES
3 2011 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Wayne A. Harper
6 Senate Sponsor: Allen M. Christensen
7
8 LONG TITLE
9 General Description:
10 This bill requires the Department of Health and the Department of Workforce Services
11 to study the state's Medicaid eligibility determination system.
12 Highlighted Provisions:
13 This bill:
14 . requires the study of the state's eligibility determination system for Medicaid to
15 determine whether consolidation of the system or privatization would create greater
16 efficiencies; and
17 . requires a report of the study to the Legislature's Health and Human Services
18 Interim Committee and the Social Services Appropriations Subcommittee prior to
19 October 20, 2011.
20 Money Appropriated in this Bill:
21 None
22 Other Special Clauses:
23 None
24 Utah Code Sections Affected:
25 ENACTS:
26 26-18-3.3, Utah Code Annotated 1953
27
28 Be it enacted by the Legislature of the state of Utah:
29 Section 1. Section 26-18-3.3 is enacted to read:

30 26-18-3.3. Study of privatization of eligibility determination.
31 (1) The department shall work with the Department of Workforce Services, the
32 Department of Human Services, and the Privatization Policy Board created in Section
33 63I-4-201 to study the state's eligibility determination system for the state Medicaid program in
34 accordance with this section.
35 (2) (a) The study shall include the state's eligibility determination system for the
36 following programs:
37 (i) the state Medicaid program;
38 (ii) the Utah Children's Health Insurance Program created under Chapter 40, Utah
39 Children's Health Insurance Act;
40 (iii) the Primary Care Network;
41 (iv) the Utah Premium Partnership; and
42 (v) other eligibility systems administered by the Department of Workforce Services.
43 (b) The study shall include:
44 (i) the workflow and operations of the eligibility determination systems for the
45 programs described in Subsection (2)(a); and
46 (ii) efficiencies that may be obtained through:
47 (A) consolidation of the eligibility determination systems;
48 (B) privatization of the eligibility determination systems; and
49 (C) other technology or organizational solutions for the eligibility determination
50 systems.
51 (3) The department, the Department of Workforce Services, and the Privatization
52 Policy Board shall, prior to October 20, 2011, report to the Legislature's Health and Human
53 Services Interim Committee and to the Social Services Appropriations Subcommittee regarding
54 the findings of the study and any recommendations and options regarding the advantages and
55 disadvantages to the state in privatizing the eligibility determination system.