The State is requesting the following:

  1. Authority to change the benefit delivery system for dental benefits for individuals with blindness or disabilities.  Benefits will be provided through the University of Utah School of Dentistry, and it’s associated statewide network of dental providers, rather than the current managed care delivery system.
  2. Authority to provide porcelain and porcelain-to-metal crowns for this population, as is currently authorized under the State’s 1115 demonstration waiver for aged individuals, and Targeted Adult Medicaid beneficiaries who are eligible for dental benefits.

The State is requesting expenditure authority to claim federal financial participation (FFP) for services provided to Medicaid beneficiaries, age 21-64, who receive inpatient psychiatric services or residential mental health treatment in an Institution for Mental Disease (IMD). Below please find the drafted 1115 Waiver amendment for public comment:

The State is requesting authority to implement provisions of House Bill 38 “Substance Use and Health Care Amendments” which passed during the 2020 Utah Legislative Session. The waiver amendment proposes to allow Utah Medicaid to provide coverage to “qualified inmates” for up to 30 days before release from a correctional facility. The following is pending CMS decision:

The State is requesting authority to implement provisions of House Bill 436 “Health and Human Services Amendments” which passed during the 2020 Utah Legislative Session. The waiver amendment proposes that the State increase the maximum UPP reimbursement amount for adults (age 19 through 64), from $150 per enrollee per month, to a higher amount through the state administrative rulemaking process, rather than by waiver amendment.

If approved, initially the maximum UPP reimbursement amount for adults will be $300 per enrollee per month. Below please find the drafted 1115 Waiver amendment for public comment:

The State is requesting authority to implement the provision of Senate Bill 96 “Medicaid Expansion Adjustments” which passed during the 2019 Utah Legislative Session. This waiver amendment proposes to increase the income limit for the Adult Expansion program to 138% federal poverty level (FPL), in addition to other program provisions and requirements. The following is pending CMS decision:

The State is requesting authority to implement the provisions of Senate Bill 96 “Medicaid Expansion Adjustments,” which passed during the 2019 Utah Legislative Session.  The following request is pending CMS decision:

Click here to see more materials and documents related to Utah’s 1115 Demonstration Waiver.