Utah Admin. Code R414-29-7 - Length of Restriction
(1) A restricted
member shall remain in the Restriction Program for a total of 12 months of
Medicaid eligibility. The months of eligibility need not be
continuous.
(2) If a restricted
member becomes ineligible for Medicaid, and subsequently reestablishes Medicaid
eligibility, the department shall require the member to continue enrollment in
the Restriction Program, unless the restricted member's loss of Medicaid
eligibility is greater than one year.
(3) The department shall perform a review of
a member's placement in the Restriction Program once the member has been
enrolled in the Restriction Program for 12 months of Medicaid
eligibility.
(4) The Restriction
Program shall remove a restricted member if an annual review demonstrates the
restricted member no longer meets the restriction criteria.
(5) The department shall inform a restricted
member in writing of the member's removal from the Restriction
Program.
(6) If at the time of
annual review, a Medicaid member still meets the criteria for the Restriction
Program, the department shall inform the restricted member of continued
enrollment in the Restriction Program for an additional 12 months of Medicaid
eligibility.
(7) The department
shall provide notice to a Medicaid member of continuation in the Restriction
Program in accordance with Section
R414-29-6.
Notes
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