Utah Medicaid

Attention Utah Medicaid pharmacy providers and members

The Utah Medicaid pharmacy vendor, Change Healthcare, experienced a network and system outage on February 21 which impacted the ability to process pharmacy claims for Medicaid members attempting to fill a prescription.  As of March 12, pharmacies are once again able to bill Utah Medicaid directly and get claims paid for member prescriptions. There is still no change from that first phase of system restoration on March 12. Technical information for pharmacies is available in the Provider FAQ.

Learn more about the Change Healthcare system disruption to Utah Medicaid in past press releases: 3/12/24, 3/8/24, 2/29/24, 2/24/24, & 2/22/24)

Medicaid experienced an issue in the state's accounting system this week which resulted in some EFTs being issued at amounts lower than the amount reported on the remittance advice. We are working to identify all providers who are impacted and will be issuing subsequent EFTs to make the payments whole. We anticipate the additional EFTs will be sent no later than July 12 and apologize for the inconvenience this may cause.


Helpful links and information for Medicaid members
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Healthcare providers

Helpful provider resources
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Managed care

Learn more about managed care
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Helpful PRISM resouces for providers
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Common Questions

What is Medicaid?

Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. To qualify, these individuals must meet income and other eligibility requirements.

Who is Eligible for Medicaid?

Medicaid is a program that covers medical expenses for certain groups of people who have limited income and resources. To learn more about the eligibility requirements, click here.

How to Apply?

You can apply for medical assistance today. You will need to complete an application and provide some documents, like a birth certificate. Click here opens in a new tab to start the online application.