- (1) The division shall notify a program when it does not meet the requirements of Subsection R414-516-3(1) and place the program on probation during the subsequent SFY.
(2) Within 30 days of receiving notice, the program shall email to qiupl@utah.gov:
- (a) a detailed description of why the facility did not comply with the requirements; and
- (b) a corrective action plan detailing how the facility will comply in the subsequent SFY.
(3) If the program fails to comply with Subsection R414-516-3(1) for a second consecutive SFY, the division shall send the program a notice of failure to meet the requirements.
(a)(i) Within 30 days of receiving notice, the program may submit a written request to remain in the seed contract, which contains evidence showing extraordinary circumstances that reasonably prevented the program from demonstrating compliance.
- (ii) Based on the evidence, the division may determine the program has provided sufficient documentation to meet the burden of proof and waive the reduced NF NSGO UPL supplemental payment for the program.
- (b) Effective the last day of the quarter in which the division determines non-compliance, the division shall reduce the NF NSGO UPL supplemental payment to the program by 15% for each metric that does not meet the requirement of Subsection R414-516-3(1) for at least 12 months of NF NSGO UPL supplemental payments.
- (c) If the division determines the program has complied with Subsection R414-516-3(1) for an entire subsequent SFY, the division shall pay the full NF NSGO UPL supplemental amount, effective the first day of the quarter after the determination is made.
KEY: Medicaid
Date of Last Change: July 2, 2025
Notice of Continuation: December 30, 2022
Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108