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7 LONG TITLE
8 General Description:
9 This bill addresses Medicaid for pregnant and postpartum women.
10 Highlighted Provisions:
11 This bill:
12 ▸ defines terms; and
13 ▸ requires the state Medicaid program to request one or more Medicaid waivers or
14 state plan amendments from the Centers for Medicare and Medicaid Services to:
15 • expand eligibility for certain limited family planning services; and
16 • extend the duration of postpartum coverage for certain women.
17 Money Appropriated in this Bill:
18 None
19 Other Special Clauses:
20 None
21 Utah Code Sections Affected:
22 AMENDS:
23 26-18-417, as last amended by Laws of Utah 2019, Chapter 393
24 ENACTS:
25 26B-3-201, Utah Code Annotated 1953
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27 Be it enacted by the Legislature of the state of Utah:
28 Section 1. Section 26-18-417 is amended to read:
29 26-18-417. Limited family planning services for low-income individuals.
30 (1) As used in this section:
31 (a) (i) "Family planning services" means family planning services that are provided
32 under the state Medicaid program, including:
33 (A) sexual health education and family planning counseling; and
34 (B) other medical diagnosis, treatment, or preventative care routinely provided as part
35 of a family planning service visit.
36 (ii) "Family planning services" do not include an abortion, as that term is defined in
37 Section 76-7-301.
38 (b) "Low-income individual" means an individual who:
39 (i) has an income level that is equal to or below [
40 level; and
41 (ii) does not qualify for full coverage under the Medicaid program.
42 (2) Before [
43 waiver or a state plan amendment with CMS to:
44 (a) offer a program that provides family planning services to low-income individuals;
45 and
46 (b) receive a federal match rate of 90% of state expenditures for family planning
47 services provided under the waiver or state plan amendment.
48 Section 2. Section 26B-3-201 is enacted to read:
49 26B-3-201. Medicaid coverage for certain postpartum women.
50 (1) As used in this section:
51 (a) "Extended postpartum period" means the period after a woman's pregnancy ends:
52 (i) beginning the day after the initial postpartum period; and
53 (ii) ending on the last day of the month that is 12 months after the day on which the
54 woman's pregnancy ends.
55 (b) "Initial postpartum period" means the period:
56 (i) beginning on the day on which a woman's pregnancy ends; and
57 (ii) ending on the last day of the month that is 60 days after the day on which the
58 woman's pregnancy ends.
59 (c) "Miscarriage" means the spontaneous or accidental loss of a fetus, regardless of
60 gestational age or the duration of the pregnancy.
61 (2) Before July 1, 2023, the division shall request a waiver or state plan amendment to,
62 in accordance with 42 U.S.C. Sec. 1396a(e)(16), provide continuous Medicaid coverage during
63 the woman's extended postpartum period if:
64 (a) the woman is eligible for Medicaid during the woman's pregnancy; and
65 (b) the woman's pregnancy ended by way of:
66 (i) birth;
67 (ii) miscarriage;
68 (iii) stillbirth; or
69 (iv) an abortion that is permitted under Section 76-7a-201.
70 (3) If the request described in Subsection (2) is denied or is not approved by January 1,
71 2024, the division shall request a waiver or state plan amendment to, in accordance with 42
72 U.S.C. Sec. 1396a(e)(16), provide continuous Medicaid coverage during the woman's extended
73 postpartum period if the woman is eligible for Medicaid during the woman's pregnancy.