(1) "Admission" means the acceptance of a
Medicaid member for inpatient hospital care and treatment when the member meets
established criteria for severity of illness and intensity of service and the
required service cannot be provided in an alternative setting.
(2) "Inpatient" is an individual whose
severity of illness and intensity of service requires continuous care in a
(3) "Inpatient Hospital
Intensive Physical Rehabilitation" means an intense program of physical
rehabilitation provided in an inpatient rehabilitation hospital or an inpatient
rehabilitation unit of a hospital.
(4) "Inpatient Hospital Services" are
services that a hospital provides for the care and treatment of inpatients.
(5) "Observation services" means
services, often less than 24 hours, including use of a bed and monitoring by
hospital staff, which are reasonable and necessary to evaluate the medical
condition or determine the need for a possible admission to the
(6) "Prepaid Mental
Health Plan" means the Medicaid mental and/or substance use disorder managed
care plan that covers inpatient and/or outpatient mental health services and
outpatient substance use disorder services for PMHP-enrolled Medicaid
Utah Admin. Code
State Bulletin Number 2018-1, effective
State Bulletin Number 2019-20, effective