This document includes Senate Committee Amendments incorporated into the bill on Thu, Feb 23, 2023 at 10:07 AM by lpoole.
This document includes Senate 3rd Reading Floor Amendments incorporated into the bill on Mon, Feb 27, 2023 at 3:20 PM by lpoole.
1     
CHRONIC CONDITIONS SUPPORT AMENDMENTS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: David P. Hinkins

5     
House Sponsor: Steve Eliason

6     

7     LONG TITLE
8     General Description:
9          This bill requires the Department of Health and Human Services to apply for a
10     Medicaid waiver to provide additional services for individuals with certain conditions.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     requires the Department of Health and Human Services to apply for a Medicaid
15     waiver to provide additional services for individuals with certain conditions; and
16          ▸     creates a reporting requirement.
17     Money Appropriated in this Bill:
18          None
19     Other Special Clauses:
20          None
21     Utah Code Sections Affected:
22     ENACTS:
23          26-18-430, Utah Code Annotated 1953
24     

25     Be it enacted by the Legislature of the state of Utah:
26          Section 1. Section 26-18-430 is enacted to read:
27          26-18-430. Medicaid waiver for rural healthcare for chronic conditions.

28          (1) As used in this section:
29          (a) "Qualified condition" means:
30          (i) diabetes;
31          (ii) high blood pressure;
32          (iii) congestive heart failure;
33          (iv) asthma;
34          (v) obesity;
35          (vi) chronic obstructive pulmonary disease; or
36          (vii) chronic kidney disease.
37          (b) "Qualified enrollee" means an individual who:
38          (i) is enrolled in the Medicaid program;
39          (ii) has been diagnosed as having a qualified condition; and
40          (iii) Ŝ→ [
resides in a county of the fourth or fifth class as described in Section 17-50-501] is
40a     not enrolled in an accountable care organization ←Ŝ .
41          (2) Before January 1, 2024, the department shall apply for a Medicaid waiver with the
42     Centers for Medicare and Medicaid Services to implement the coverage described in
43     Subsection (3) Ŝ→ for a three-year pilot program ←Ŝ .
44          (3) If the waiver described in Subsection (2) is approved, the Medicaid program shall
45     contract with a single entity to provide coordinated care for the following services Ŝ→ [
for one
45a     year
] ←Ŝ
46     to each qualified enrollee:
47          (a) a telemedicine platform for the qualified enrollee to use;
48          (b) an in-home initial visit to the qualified enrollee;
49          (c) daily remote monitoring of the qualified enrollee's qualified condition;
50          (d) all services in the qualified enrollee's language of choice;
51          (e) individual peer monitoring and coaching for the qualified enrollee;
52          (f) available access for the qualified enrollee to video-enabled consults and
53     voice-enabled consults 24 hours a day, seven days a week;
54          (g) in-home biometric monitoring devices to monitor the qualified enrollee's qualified
55     condition; and
56          (h) at-home medication delivery to the qualified enrollee.
57          (4) The Medicaid program may not provide the coverage described in Subsection (3)
58     until the waiver is approved.

59          (5) Ŝ→ [
The] Each year the waiver is active, the ←Ŝ department shall submit a report to
59a     the Health and Human Services Interim
60     Committee before November 30 Ŝ→ [
, 2025,] ←Ŝ detailing:
61          (a) the number of patients served under the waiver;
62          (b) the cost of the waiver Ŝ→ [
or state plan amendment] ←Ŝ ; and
63          (c) any benefits of the waiver Ŝ→ [
or state plan amendment] ←Ŝ , including an estimate of:
64          (i) the reductions in emergency room visits or hospitalizations;
65          (ii) the reductions in 30-day hospital readmissions for the same diagnosis;
66          (iii) the reductions in complications related to qualified conditions; and
67          (iv) any improvements in health outcomes from baseline assessments.