Obsolete 0120 - What's New

Sections

What's New

215-2  Who is a Resident of a Household

215-6  Residents of Non-Medical Institutions

604  Suspension of Benefits (New)

• Individuals who become incarcerated will no longer have the medical coverage closed or denied, but will have the coverage placed in a 'suspended' status.  

• Utah Naloxone is now an approved TAM provider.

354 Foster Care Medicaid

354-4 Foster Care Independent Living

• Foster care youth can receive Former Foster Care and Foster Care Independent Living coverage if they received Medicaid at any time during the foster care period in which they turned age 18, or a higher age at which the state or tribe's foster care assistance ends.
• Individuals are eligible for Foster Care Independent Living regardless of which state they were in when aging out of foster care.

• DWS can now only deny a providers presumptive determination if the individual is already on a medical program or the form 40 is submitted after a determination of ongoing medical coverage has been completed.

• Utility allowances were updated for the HCB shelter deduction.

• Eye glasses can now be deducted for spenddown and cost-of-care at a rate higher than the Medicaid rate.

346 Targeted Adult Medicaid

346 Resource - TAM Open Enrollment (New)

731-8 Verification for TAM

Table XVII - Approved TAM Providers

• The 3rd TAM group "Individuals Needing Treatment" is opening for enrollment July 1st.  
• New resource to list the status of open or closed enrollment for the TAM groups.
• For the General Assistance sub-group, agencies that can complete the new form 45A are noted on Table XVII.  

348 Adult Expansion

348-1 Adult Expansion Open Enrollment Periods (New)

1004 Income Standards

• Clarified the hierarchy in regards to the Adult group and removed the retroactive language (Moved to 348-1).
• Added new section explaining the open enrollment process and that American Indians are exempt from the open enrollment process.
• Clarified the income standards for UPP.

835 Estate Recovery

835 Resource - Estate Recovery (Obsolete)

• Estate recovery has been updated and the obsolete resource information incorporated into Section 348.
• Added policy about the new TEFRA liens.

Table II - ABD Figures, Income Limits and Other Important Figures

Table II-A - LTC and Waiver Income Limits and Other Important Figures

• Updated the 1619B income limit.
• Updated the spousal needs allowance and shelter standard.

• Added Weber County Sheriff's Kiesel Facility to approved halfway house table.

• Removed reference of prepaid mental health plans, as they no longer provide transportation.

• Clarified there is no sponsor deeming for MAGI programs.
• Clarified an individual on strike does not affect Medicaid coverage.
• Clarified Medicare Part B TPL requirements.
• Clarified DWS will notify DOH when an individual is exempt from cost sharing.

• Clarifying that individuals eligible for the Breast and Cervical Cancer Program (BCC)are to stay on BCC and not move to the new Adult Expansion program.  This also affects other medical programs.

• These sections were modified to include the new Adult Expansion coverage group that goes into effect April 1, 2019.  PCN will no longer be a coverage group.

• The PCR income limit decreased and is no longer based on the FPL, but a set monthly figure.
• Removed PCN and replaced with Adult Expansion.
• The TAM income limit increased and is set at 5% FPL.

• PCN references were removed as PCN will no longer be a coverage group as of April 1, 2019.
• PCN reference were not removed from the Section 303 due to still being applicable for some disability determination.

• Clarified where and how a client can request a fair hearing.

• Clarified the availability of assets converting from one form or another and the treatment of assets held by someone other than the client.

• Tables were updated to reflect new FPL figures.

• Utah Harm Reduction Coalition (UHRC) has been added to Table XVII.

• The term CHEC is being replaced with EPSDT (Early and Periodic Screening, Diagnostic and Treatment).

• Tables were update to reflect SSA Cola increase.

• MATR has been added to Table XVII and Table XVIII.