Chief Sponsor: James A. Dunnigan

Senate Sponsor: Allen M. Christensen


8     General Description:
9          This bill addresses reimbursement for certain inpatient mental health services under
10     Medicaid.
11     Highlighted Provisions:
12          This bill:
13          ▸     directs the Department of Health to apply for a waiver or a state plan amendment
14     with Medicaid to offer a program to provide reimbursement for certain inpatient
15     mental health services.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          None
20     Utah Code Sections Affected:
21     ENACTS:
22          26-18-420, Utah Code Annotated 1953

24     Be it enacted by the Legislature of the state of Utah:
25          Section 1. Section 26-18-420 is enacted to read:
26          26-18-420. Medicaid waiver for inpatient care in an institution for mental
27     diseases.
28          (1) As used in this section, "institution for mental diseases" means the same as that
29     term is defined in 42 C.F.R. Sec. 435.1010.

30          (2) Before August 1, 2020, the division shall apply for a Medicaid waiver or a state
31     plan amendment with CMS to offer a program that provides reimbursement for mental health
32     services that are provided:
33          (a) in an institution for mental diseases that includes more than 16 beds; and
34          (b) to an individual who receives mental health services in an institution for mental
35     diseases for a period of more than 15 days in a calendar month.
36          (3) If the waiver or state plan amendment described in Subsection (2) is approved, the
37     department shall:
38          (a) coordinate with the Department of Human Services to develop and offer the
39     program described in Subsection (2); and
40          (b) submit to the Health and Human Services Interim Committee and the Social
41     Services Appropriations Subcommittee any report that the department submits to CMS that
42     relates to the budget neutrality, independent waiver evaluation, or performance metrics of the
43     program described in Subsection (2), within 15 days after the day on which the report is
44     submitted to CMS.
45          (4) Notwithstanding Sections 17-43-201 and 17-43-301, if the waiver or state plan
46     amendment described in Subsection (2) is approved, a county does not have to provide
47     matching funds to the state for the mental health services described in Subsection (2) that are
48     provided to an individual who qualifies for Medicaid coverage under Section 26-18-3.9 or
49     Section 26-18-411.