Utah Admin. Code R398-30-5 - Awarding Financial Assistance to Recipients

(1) Prior to awarding financial assistance, the committee shall review the recipient's application for assistance to determine:

(a) the needs of the recipient both medically and financially; and

(b) the existence of other financial assistance, including the availability of insurance or other state aid.

(2) Each listed or transplant recipient must apply for Medicaid, Children's Health Insurance Program assistance, or other public health coverage provided by the state, before the committee agrees to award any financial assistance.

(3) As part of the review process, the responsible party of the recipient shall sign a release to allow all medical records of the child to be released to the Department.

(4) As a part of the review process, the committee shall consider:

(a) the success rate of the particular organ transplant procedure needed by the child; and

(b) the extent of the threat to the child's life without the organ transplant.

(5) In addition, the committee shall consider the availability of funds before awarding financial assistance. The committee may create a waiting list and prioritize the list by financial and medical needs. A financial assistance award is not an entitlement. The fund should not incur a deficit.

(6) The Department shall create a recipient file that shall include information such as: the application, related documentation, correspondence, repayment plans, repayment amounts and the approved contract. This file and documentation will be stored securely for ten years after the recipient reaches the age of 18.

(7) The committee may review and determine if the recipient is ineligible to receive funds when:

(a) the recipient's account has been reviewed and found to be inactive for two years;

(b) the Department has made three documented attempts to contact the responsible party or recipient to discuss inactivity without response;

(c) there is a violation of the terms of the executed contract;

(d) two years have passed since the transplant; or

(e) the recipient is no longer a Utah resident.

Notes

Utah Admin. Code R398-30-5

Adopted by Utah State Bulletin Number 2015-10, effective 4/20/2015 Amended by Utah State Bulletin Number 2020-04, effective 1/27/2020