1. (1)(a) The department implements 42 CFR 433.138(b), on the collection of health insurance information.

   1. (b) The department implements Subsection 1915(b) of the Compilation of the Social Security Laws.
2. (2) The department requires members to report any changes in third-party liability information within 30 days.
3. (3) The department considers a member uncooperative if the member knowingly withholds third-party liability information without good cause.
4. (4) The department shall decide whether employer-provided group health insurance would be cost effective for the state to purchase as a benefit of Medicaid.
5. (5) The department requires members residing in selected communities to be enrolled in a Health Maintenance Organization (HMO) as their primary care provider.

6. (6)(a) The department shall enroll and select an HMO for members who do not make a selection.

   1. (b) The department shall notify members of the HMO they are enrolled in and allow them ten days to contact the department with a different selection.
   2. (c) If the member fails to notify the department to make a different selection within ten days, the enrollment shall become effective for the next benefit month.

KEY: state residency, citizenship, third-party liability, Medicaid

Date of Last Change: January 22, 2024

Notice of Continuation: January 6, 2023

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