Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 200 First Substitute (2022GS)

Sponsor

Rep. Eliason, S.

Final action

Governor Signed 3/23/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• amends application, eligibility, treatment, and evaluation provisions for the Medicaid program for children with complex medical conditions.

Every vote on this bill

Bill text

MEDICAID WAIVER FOR MEDICALLY COMPLEX
CHILDREN AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Steve Eliason
Senate Sponsor: 
Curtis S. Bramble
LONG TITLE
General Description:
This bill amends the Medical Assistance Act.
Highlighted Provisions:
This bill:
▸ amends application, eligibility, treatment, and evaluation provisions for the
Medicaid program for children with complex medical conditions.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-18-410
, as last amended by Laws of Utah 2019, Chapter 393
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-18-410
 is amended to read:
26-18-410.
Medicaid waiver for children with disabilities and complex medical
needs.
(1) As used in this section:
(a) "Additional eligibility criteria" means the additional eligibility criteria set by the
department under Subsection (4)(e).
(b) "Complex medical condition" means a physical condition of an individual that:
(i) results in severe functional limitations for the individual; and
(ii) is likely to:
(A) last at least 12 months; or
(B) result in death.
(c) "Program" means the program for children with complex medical conditions
created in Subsection (3).
(d) "Qualified child" means a child who:
(i) is less than 19 years old;
(ii) is diagnosed with a complex medical condition;
(iii) has a condition that meets the definition of disability in 42 U.S.C. Sec. 12102; and
(iv) meets the additional eligibility criteria.
(2) The department shall apply for a Medicaid home and community-based waiver with
CMS to implement, within the state Medicaid program, the program described in Subsection
(3).
(3) If the waiver described in Subsection (2) is approved, the department shall offer a
program that:
(a) as funding permits, provides treatment for qualified children;
(b) if approved by CMS and as funding permits, beginning in fiscal year 2023 provides
on an ongoing basis treatment for 130 more qualified children than the program provided
treatment for during fiscal year 2022; and
[
(b)
] 
(c)
 accepts applications for the program [
during periods of open enrollment; and
]
on an ongoing basis.
[
(c) if approved by CMS:
]
(i) requires periodic reevaluations of an enrolled child's eligibility 
and other applicants
or eligible children waiting for services in the program
 based on the additional eligibility
criteria; and
(ii) at the time of reevaluation, allows the department to disenroll a child [
who does not
meet the
] 
based on the prioritization described in Subsection (4)(a) and
 additional eligibility
criteria.
(4) The department shall:
[
(a) seek to prioritize, in the waiver described in Subsection (2), entrance into the
program based on the:
]
(a) establish by rule made in accordance with Title 63G, Chapter 3, Utah
Administrative Rulemaking Act, criteria to prioritize qualified children's participation in the
program based on the following factors, in the following priority order:
(i) 
the
 complexity of a qualified child's medical condition; and
(ii) 
the
 financial needs of [
a
] 
the
 qualified child and the qualified child's family;
(b) convene a public process to determine[
:(i)
] the benefits and services to offer a
qualified child under the program; [
and
]
[
(ii) additional eligibility criteria for a qualified child;
]
(c) evaluate, on an ongoing basis, the cost and effectiveness of the program;
(d) if funding for the program is reduced, develop an evaluation process to reduce the
number of children served based on the 
participation
 criteria [
in
] 
established under
 Subsection
(4)(a); and
(e) establish, by rule made in accordance with Title 63G, Chapter 3, Utah
Administrative Rulemaking Act, additional eligibility criteria based on the factors described in
Subsections (4)(a)(i) and (ii).