Utah Admin. Code R414-1-28 - Provider-Preventable Conditions

Current through Bulletin 2022-07, April 1, 2022

(1) In accordance with 42 CFR 447.26, October 1, 2011 ed., which is incorporated by reference, Medicaid will not reimburse providers or contractors for provider-preventable conditions as noted therein. Please see Utah Medicaid State Plan Attachments 4.19-A and 4.19-B for detail.
(2) Medicaid providers who treat Medicaid eligible patients must report all provider-preventable conditions whether or not reimbursement for the services is sought. Medicaid providers shall meet this requirement by complying with existing state reporting requirements (rules and legislation) of these events that include:
(a) Rule R380-200;
(b) Rule R380-210;
(c) Rule R386-705;
(d) Rule R428-10; and
(e) Section 26-6-31.
(3) Utilizing the reporting mechanism from one of the rules noted above shall not impact confidentiality and privacy protections for reporting entities as noted in Title 26, Chapter 25, Confidential Information Release.


Utah Admin. Code R414-1-28
Amended by Utah State Bulletin Number 2017-14, effective 7/1/2017

The following state regulations pages link to this page.

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.