Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-515 - Long Term Acute Care
Section R414-515-4 - Program Access Requirements
Universal Citation: UT Admin Code R 414-515-4
Current through Bulletin 2024-06, March 15, 2024
(1)
(a) A member must meet the severity of
illness and intensity of service for LTAC hospital level -of -care as
determined through an evidence-based criteria review process.
(b) The Department shall deny an LTAC request
for reimbursement if the member does not meet the evidence-based
criteria.
(2) The Department may forward LTAC preadmissions, continued stays, and retroactive stays that do not meet the evidence-based criteria for secondary medical review if:
(a) the LTAC provider requests the
secondary medical review; or
(b)
review of documentation shows that LTAC is the most appropriate level -of -care
for the member.
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