Utah Admin. Code R414-29-1 - Introduction and Authority

(1) This rule sets out the criteria and process to restrict a Medicaid member to specific Medicaid providers if the member is found to have a pattern of using Medicaid services at a frequency or amount not medically necessary.

(2) This rule implements the requirements found in 42 CFR 431.54(e) and 42 CFR 456.3.

Notes

Utah Admin. Code R414-29-1

Adopted by Utah State Bulletin Number 2021-22, effective 11/1/2021 Amended by Utah State Bulletin Number 2024-21, effective 10/28/2024