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7 LONG TITLE
8 General Description:
9 This bill addresses Medicaid coverage for children under age 19 with a disability.
10 Highlighted Provisions:
11 This bill:
12 ▸ defines terms; and
13 ▸ requires the Department of Health and Human Services to submit a Medicaid state
14 plan amendment to provide treatment to qualified enrollees who live at home and
15 meet the financial eligibility criteria established in the state plan.
16 Money Appropriated in this Bill:
17 None
18 Other Special Clauses:
19 None
20 Utah Code Sections Affected:
21 ENACTS:
22 26-18-430, Utah Code Annotated 1953
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24 Be it enacted by the Legislature of the state of Utah:
25 Section 1. Section 26-18-430 is enacted to read:
26 26-18-430. Medicaid coverage for children under age 19 with a disability.
27 (1) As used in this section:
28 (a) "Existing home and community-based services waiver" means the existing home
29 and community-based services waiver in the state described in Section 26-18-410.
30 (b) "Qualified enrollee" means an individual:
31 (i) who is less than 19 years old;
32 (ii) who is not served under an existing home and community-based services waiver;
33 (iii) who, because of a physical, intellectual, or developmental disability, meets the
34 level of care criteria for admission to a hospital, nursing facility, or intermediate care facility
35 and can receive such care at home; and
36 (iv) for whom the department has determined that providing care at home would cost
37 no more than it would cost to provide that care in a setting described in Subsection (1)(b)(iii).
38 (2) Before July 1, 2024, the department shall apply with CMS for a state plan
39 amendment to provide treatment to qualified enrollees who live at home and meet the financial
40 eligibility criteria established in the state plan.
41 (3) If the state plan amendment described in Subsection (2) is approved, the department
42 shall offer a program that provides treatment for qualified enrollees.