Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-505 - Participation in the Nursing Facility Non-State Government-Owned Upper Payment Limit Program
Section R414-505-5 - Requirements to Participate in the NF NSGO UPL Program
Universal Citation: UT Admin Code R 414-505-5
Current through Bulletin 2024-06, March 15, 2024
(1)
(a) An
NSGE must own the nursing care facility.
(b) Before the Medicaid agency initiates a
contract, the nursing care facility owner shall provide appropriate legal
evidence, as determined by the Medicaid agency, demonstrating an NSGE owns the
nursing care facility.
(c) A
nursing care facility participating in this supplemental payment program must
notify the Office of Financial Services at the email address noted in Section
R414-505-4, of changes in
ownership that may affect the nursing care facility's continued eligibility
within 14 calendar days after the change.
(2) The Medicaid provider enrollment process must be complete.
(3)
(a) The NSGE must have an NF NSGO UPL
contract in effect, signed by the Department's authorized
representative.
(b) The effective
date for an NF NSGO UPL contract for a nursing care facility to participate in
the NF NSGO UPL supplemental payments must be the latter of the following
dates:
(i) the effective date of the change
of ownership;
(ii) the email date
of the notice of intent to participate as noted in Section
R414-505-4; or
(iii) the effective date of the Medicaid
provider enrollment.
(4) Once a contract is in effect, the Department shall make payments in accordance with Attachment 4.19-D of the Medicaid State Plan and the NF NSGO UPL contract.
(5)
(a)
State funding for supplemental payments authorized in this rule is limited to
and obtained through intergovernmental transfer (IGT) agreements of public
funds or other permissible source-of-seed funding from the NSGE that holds the
license and is party to the Medicaid contract of the nursing care
facility.
(b) The NSGE shall ensure
that the funds provided to the Department for the non-federal share, via IGT,
meet the requirements of 42
CFR 433 Subpart B.
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.
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