Utah Admin. Code R414-302-9 - Third-Party Liability
(1)
(a) The department implements
42 CFR
433.138(b), on the
collection of health insurance information.
(b) The department implements Subsection
1915(b) of the Compilation of the Social Security Laws.
(2) The department requires members to report
any changes in third -party liability information within 30 days.
(3) The department considers a member
uncooperative if the member knowingly withholds third-party liability
information without good cause.
(4)
The department shall decide whether employer -provided group health insurance
would be cost effective for the state to purchase as a benefit of
Medicaid.
(5) The department
requires members residing in selected communities to be enrolled in a Health
Maintenance Organization (HMO) as their primary care provider.
(6)
(a) The
department shall enroll and select an HMO for members who do not make a
selection.
(b) The department shall
notify members of the HMO they are enrolled in and allow them ten days to
contact the department with a different selection.
(c) If the member fails to notify the
department to make a different selection within ten days, the enrollment shall
become effective for the next benefit month.
Notes
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