26B-5-383. Directed payments.
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Effective 5/7/2025
26B-5-383. Directed payments.
(1)To preserve and improve access to behavioral health hospital services, the department shall incorporate into the local mental health authorities' Medicaid prepaid mental health plan contract rate structure calculation, consistent with the certified actuarial rate range, an amount equal to the difference between payments made by local mental health authorities for the Medicaid eligibility categories for Medicaid-eligible services covered in Utah based on submitted encounter data and the maximum amount that could be paid for those services to be used for directed payments to the Utah State Hospital and the Huntsman Mental Health Institute within the University of Utah for inpatient and outpatient behavioral health services.
(2)By June 30, 2025, the department shall submit to the Centers for Medicare and Medicaid Services the necessary request and supporting documentation to seek approval to make the Medicaid directed payments described in Subsection
(1)with an effective date of July 1, 2025.
(3)The department may implement directed payments for the Utah State Hospital when operationally feasible.
Enacted by Chapter 499 , 2025 General Session