1. (1) This rule incorporates by reference the Utah Health Information Network's (UHIN) "Adaptive Behavior Services/Applied Behavior Analysis (ABA) Billing Standard" version 3.1, which is available on the department's website at https://insurance.utah.gov or on UHIN's website at https://uhin.org.
2. (2) A carrier shall use the UHIN "Adaptive Behavior Services/Applied Behavior Analysis (ABA) Billing Standard" version 3.1 to identify and report state-required benefit claims subject to defrayal under Subsection R590-283-4(2)(c) and this section.

3. (3)(a) To project the state's defrayal payments, a carrier anticipating a defrayal payment shall submit to the commissioner on a quarterly basis the Mandate Defrayal Data template for the current reporting period.

   1. (b) A report shall be filed:

      1. (i) on or before May 15 of each year for the period January 1 through March 31;
      2. (ii) on or before August 15 of each year for the period January 1 through June 30;
      3. (iii) on or before November 15 of each year for the period January 1 through September 30;
      4. (iv) on or before February 15 of each year for the period January 1 through December 31 of the previous year; and
      5. (v) for the purpose of Section R590-283-4, on or before September 1 of each year for the period January 1 through December 31 of the previous year.
4. (4) Reports shall be submitted via the System for Electronic Rate and Form Filings, SERFF.

KEY: insurance

Date of Last Change: June 9, 2023

Notice of Continuation: December 16, 2024

Authorizing, and Implemented or Interpreted Law: 31A-30-118(4)