Waiver Documents
Below are materials and documents related to Utah’s 1115 Demonstration Waiver:
Some of the following materials were created prior to the merger between the Utah Department of Health (UDOH) and the Utah Department of Human Services (UDHS). These materials are required by federal or state statute to remain on our website.
Final 1115 Demonstration Amendment Versions-CMS
- Medicaid Reform 1115 Demonstration Amendment - Twelve-month Extended Postpartum Coverage (Submitted 5.16.23) opens in a new tab
- Medicaid Reform 1115 Demonstration Amendment - Adult Dental (Submitted 7.27.23) opens in a new tab
- Medicaid Reform 1115 Demonstration Amendment - Family Planning Services (Submitted 7.27.23) opens in a new tab
- Medicaid Reform 1115 Demonstration Amendment - Chronic Conditions Support (Submitted 7.27.23) opens in a new tab
- Medicaid Reform 1115 Demonstration Amendment - UPP Premium Increase for Children (Submitted 4.10.23) opens in a new tab
- Medicaid Reform 1115 Demonstration Amendment - Long Term Services and Supports for Behaviorally Complex Individuals (Submitted 12.30.22) opens in a new tab
- Medicaid Reform 1115 Demonstration Amendment - Integrated Behavioral Health Services (Submitted 12.30.22) opens in a new tab
- 1115 Waiver Amendment- Fertility Preservation for Individuals Diagnosed with Cancer (Sumbitted 12.27.2021) opens in a new tab
- 1115 Waiver Amendment-Medical Respite Care (Submitted 12.27.2021) opens in a new tab
- 1115 Waiver Amendment - UPP Premium Reimbursement Increase (2.23.2021) opens in a new tab
- 1115 Waiver Amendment - IVF and Genetic Testing (Submitted 12.31.20) opens in a new tab
- 1115 Waiver Amendment - Dental Benefits for Individuals with Blindness - Disabilities (Submitted 9.11.20) opens in a new tab
- 1115 Waiver Amendment – Behavioral Health Services for Adults with Serious Mental Illness (Submitted 8.3.20) opens in a new tab
- 1115 Waiver Amendment – Medicaid Coverage for Justice-Involved Populations (Submitted 6.29.20) opens in a new tab
- 1115 Demonstration Waiver Amendment – Fallback Plan (Submitted 11.1.19) opens in a new tab
- 1115 Demonstration Waiver Amendment – Utah Medicaid Integrated Care (Submitted 8.28.19) opens in a new tab
- 1115 Demonstration Application – Per Capita Cap (Submitted 7.31.19) opens in a new tab
- Aged Dental and Porcelain Crowns Amendment (Submitted 6.28.19) opens in a new tab
- Adult Social Detoxification Covered Service Amendment (Submitted 2.6.19) opens in a new tab
- 1115 Demonstration Waiver – Family Planning Services, Targeted Adult Dental, and At-risk Youth Amendment Request (Submitted 6.29.18) opens in a new tab
- 1115 Demonstration Waiver – Adult Expansion Amendment Request (Submitted 6.21.18) opens in a new tab
- 1115 Waiver Revisions (Submitted 8.15.17) opens in a new tab
- Dental Benefits for Adults with Disabilities or Blindness (Submitted 1.31.17) opens in a new tab
- 1115 Demonstration Waiver (Submitted 8.18.16) opens in a new tab
- Community Service Medicaid Pilot Program (Submitted 12.30.11)
Public Comment Draft Amendment Versions
- HRSN Amendment
- Adult Dental Draft Amendmentopens in a new tab
- Adult Expansion Amendment opens in a new tab
- Aged Dental and Porcelain Crowns Amendment opens in a new tab
- Behavioral Health Services for Adults with Serious Mental Illness Amendment opens in a new tab
- Chronic Conditions Support Draft Amendment opens in a new tab
- Dental Benefits for Individuals with Blindness and Disabilities opens in a new tab
- Fallback Plan Amendment opens in a new tab
- Family Planning Services Amendment opens in a new tab
- Family Planning Services Draft Amendment opens in a new tab
- Fertility Treatments for Individuals Diagnosed with Cancer opens in a new tab
- Integrated Behavioral Health Services Draft Amendment opens in a new tab
- In Vitro Fertilization and Genetic Testing for Qualified Conditions Amendment opens in a new tab
- Long Term Services and Supports for Behaviorally Complex Individuals Draft Amendment opens in a new tab
- Medicaid Coverage for Justice-Involved Populations Amendment opens in a new tab
- Medical Respite Care opens in a new tab
- Per Capita Cap Application opens in a new tab
- Services for At Risk Medicaid Eligible Children/Youth opens in a new tab
- Social Detoxification Amendment opens in a new tab
- Targeted Adult Medicaid/SUD Dental Benefits opens in a new tab
- Twelve-month Extended Postpartum Draft Amendment opens in a new tab
- UPP Premium Reimbursement Increase Amendment opens in a new tab
- UPP Reimbursement Increase for Children Draft Amendment opens in a new tab
- Utah Medicaid Integrated Care Amendment opens in a new tab
Special Terms and Conditions
Waiver Renewal Drafts
- Waiver Renewal (Submitted 9.7.21) opens in a new tab
- Waiver Renewal (Submitted 6.30.21) opens in a new tab
- Waiver Renewal Document opens in a new tab
Monitoring Protocols
Other Documents and Materials
- Phase-Out Plan Clinically Managed Residential Withdrawal Services
- Approved 1115 Medicaid Reform 1115 Demonstration
- Twelve-Month Extended Postpartum Coverage - CMS denial letter opens in a new tab
- Medicaid Expansion: At-A-Glance Chart (Senate Bill 96) opens in a new tab
- 2018 1115 Waiver Amendments Overview opens in a new tab