Utah Code 26B-3-217. Medicaid waiver for coverage of qualified inmates leaving prison or jail
Current as of: 2024 | Check for updates
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(1) As used in this section:
Terms Used In Utah Code 26B-3-217
- Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
- CMS: means the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services. See Utah Code 26B-3-101
- Contract: A legal written agreement that becomes binding when signed.
- Division: means the Division of Integrated Healthcare within the department, established under Section 26B-3-102. See Utah Code 26B-3-101
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
- United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5
(1)(a) “Correctional facility” means:
(1)(a)(i) a county jail;
(1)(a)(ii) a prison, penitentiary, or other institution operated by or under contract with the Department of Corrections for the confinement of an offender, as defined in Section 64-13-1 ; or
(1)(a)(iii) a facility for secure confinement of minors operated by the Division of Juvenile Justice and Youth Services.
(1)(b) “Limited Medicaid benefit” means:
(1)(b)(i) reentry case management services;
(1)(b)(ii) physical and behavioral health clinical services;
(1)(b)(iii) medications and medication administration;
(1)(b)(iv) medication-assisted treatment, including all United States Food and Drug Administration approved medications, including coverage for counseling; and
(1)(b)(v) other services as determined by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(1)(c) “Qualified inmate” means an individual who:
(1)(c)(i) is incarcerated in a correctional facility; and
(1)(c)(ii) is ineligible for Medicaid as a result of incarceration but would otherwise qualify for Medicaid.
(2) Subject to appropriation, before July 1, 2024, the division shall apply for a Medicaid waiver, or amend an existing Medicaid waiver application, with CMS to offer a program to provide a limited Medicaid benefit to a qualified inmate for up to 90 days immediately before the day on which the qualified inmate is released from a correctional facility.
(3)
(3)(a) Savings to state and local funds that result from the use of federal funds provided under this section shall be used in accordance with a reinvestment plan as mandated by CMS.
(3)(b) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the department shall make rules for a participating county to establish a reinvestment plan described in Subsection (3)(a).
(4) If the waiver or amended waiver described in Subsection (2) is approved, the department shall report to the Health and Human Services Interim Committee each year before November 30 while the waiver is in effect regarding:
(4)(a) the number of qualified inmates served under the program;
(4)(b) the cost of the program; and
(4)(c) the effectiveness of the program, including:
(4)(c)(i) any reduction in the number of emergency room visits or hospitalizations by inmates after release from a correctional facility;
(4)(c)(ii) any reduction in the number of inmates undergoing inpatient treatment after release from a correctional facility;
(4)(c)(iii) any reduction in overdose rates and deaths of inmates after release from a correctional facility; and
(4)(c)(iv) any other costs or benefits as a result of the program.
(5) Before July 1, 2024, the department shall amend the Medicaid waiver related to housing support services to include an individual that was a qualified inmate within the previous 12 months.
(6) The department may elect to not apply for a Medicaid waiver or limit services described in this section based on appropriation.