26B-3-217. Medicaid waiver for coverage of qualified inmates leaving prison or jail.

503 words·~2 min read·/ut/title-26b/chapter-3/26b-3-217

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 5/7/2025

(1)As used in this section:

(a)"Certified community health worker" means an individual who has obtained the certification described in Section 26B-2-504 .

(b)"Correctional facility" means:

(i)a county jail;

(ii)a prison, penitentiary, or other institution operated by or under contract with the Department of Corrections for the confinement of an offender, as defined in Section 64-13-1 ; or

(iii)a facility for secure confinement of minors operated by the Division of Juvenile Justice and Youth Services.

(c)"Limited Medicaid benefit" means:

(i)reentry case management services;

(ii)physical and behavioral health clinical services;

(iii)medications and medication administration;

(iv)medication-assisted treatment, including all United States Food and Drug Administration approved medications, including coverage for counseling;

(v)services provided by a certified community health worker; and

(vi)other services as determined by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.

(d)"Qualified inmate" means an individual who:

(i)is incarcerated in a correctional facility; and

(ii)is ineligible for Medicaid as a result of incarceration but would otherwise qualify for Medicaid.

(2)Subject to appropriation, before July 1, 2024, the division shall apply for a Medicaid waiver, or amend an existing Medicaid waiver application, with CMS to offer a program to provide a limited Medicaid benefit to a qualified inmate for up to 90 days immediately before the day on which the qualified inmate is released from a correctional facility.

(a)Savings to state and local funds that result from the use of federal funds provided under this section shall be used in accordance with a reinvestment plan as mandated by CMS.

(b)In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the department shall make rules for a participating county to establish a reinvestment plan described in Subsection (3)(a).

(4)If the waiver or amended waiver described in Subsection

(2)is approved, the department shall report to the Health and Human Services Interim Committee each year before November 30 while the waiver is in effect regarding:

(a)the number of qualified inmates served under the program;

(b)the cost of the program; and

(c)the effectiveness of the program, including:

(i)any reduction in the number of emergency room visits or hospitalizations by inmates after release from a correctional facility;

(ii)any reduction in the number of inmates undergoing inpatient treatment after release from a correctional facility;

(iii)any reduction in overdose rates and deaths of inmates after release from a correctional facility; and

(iv)any other costs or benefits as a result of the program.

(5)Before July 1, 2024, the department shall amend the Medicaid waiver related to housing support services to include an individual that was a qualified inmate within the previous 12 months.

(6)The department may elect to not apply for a Medicaid waiver or limit services described in this section based on appropriation.

Amended by Chapter 135 , 2025 General Session