Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-511 - Medicaid Accountable Care Organization Incentives to Appropriately Use Emergency Room Services
Section R414-511-3 - Performance Measures
Universal Citation: UT Admin Code R 414-511-3
Current through Bulletin 2024-06, March 15, 2024
(1) An ACO that contracts with the department to provide services to Medicaid members shall report the following information to the department in accordance with the terms of its contract:
(a) emergency room visits
with low acuity CPT codes 99281 or 99282;
(b) actions the ACO takes to expand primary
care and urgent care for Medicaid members who are enrolled in the Accountable
Care Plan; and
(c) actions the ACO
takes to implement emergency room diversion plans that include:
(i) weekday, evening, and weekend access to
primary care providers and community health centers for Medicaid
beneficiaries;
(ii) other
innovations for expanding access to primary care; and
(iii) other quality of care for Medicaid
members who are enrolled in an ACO as required by the department.
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.
