Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-29 - Client Review and Restriction Policy
Section R414-29-6 - Notification of Placement in Restriction Program
Universal Citation: UT Admin Code R 414-29-6
Current through Bulletin 2024-06, March 15, 2024
(1) The Department shall provide written notice to a Medicaid member that the Department is placing the member in the Restriction Program at least 10 days before placing the member in the Restriction Program. The notice shall inform the member of:
(a) the effective date of the member's
placement in the Restriction Program;
(b) the basis for the member's placement in
the Restriction Program;
(c) the
specific element of the restriction criteria that supports the placement of the
member in the Restriction Program; and
(d) the assigned PCP and assigned pharmacy
selected for the member, and known assigned providers and assigned prescribers
for the member at the time of placement in the Restriction Program.
(2) The notice shall inform the member that:
(a) upon placement in the
Restriction Program, the member's assigned PCP must authorize Medicaid-covered
prescriptions, primary care, and specialty care services for payment to be
made; and
(b) the member has the
right to an administrative hearing, including appropriate forms, instructions,
and information sufficient to request an administrative hearing and the time
frame for requesting an administrative hearing.
Disclaimer: These regulations may not be the most recent version. Utah may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
