1. (1) In accordance with 42 CFR 447.26, Medicaid will not reimburse providers or contractors for provider-preventable conditions as noted therein. Please see Utah Medicaid State Plan Attachments 4.19-A and 4.19-B for detail.

2. (2) Medicaid providers who treat Medicaid eligible patients must report provider-preventable conditions whether or not reimbursement for the services is sought. Medicaid providers shall meet this requirement by complying with existing state reporting requirements of these events that include:

   1. (a) Rule R380-200;
   2. (b) Rule R386-705;
   3. (c) Rule R428-10; and
   4. (d) Section 26B-7-221.
3. (3) Utilizing the reporting mechanism from one of the rules noted above may not impact confidentiality and privacy protections for reporting entities as noted in Title 26B, Chapter 1 Department of Health and Human Services.

KEY: Medicaid

Date of Last Change: May 1, 2026

Notice of Continuation: December 13, 2021

Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108; 26B-3-1004; 26B-8-132