Utah Admin. Code R414-505-5 - Requirements to Participate in the NF NSGO UPL Program

(1)

(a) An NSGE must own the nursing care facility.

(b) Before the Medicaid agency initiates a contract, the nursing care facility owner shall provide appropriate legal evidence, as determined by the Medicaid agency, demonstrating an NSGE owns the nursing care facility.

(c) A nursing care facility participating in this supplemental payment program must notify the Office of Financial Services at the email address noted in Section R414-505-4, of changes in ownership that may affect the nursing care facility's continued eligibility within 14 calendar days after the change.

(2) The Medicaid provider enrollment process must be complete.

(3)

(a) The NSGE must have an NF NSGO UPL contract in effect, signed by the Department's authorized representative.

(b) The effective date for an NF NSGO UPL contract for a nursing care facility to participate in the NF NSGO UPL supplemental payments must be the latter of the following dates:

(i) the effective date of the change of ownership;

(ii) the email date of the notice of intent to participate as noted in Section R414-505-4; or

(iii) the effective date of the Medicaid provider enrollment.

(4) Once a contract is in effect, the Department shall make payments in accordance with Attachment 4.19-D of the Medicaid State Plan and the NF NSGO UPL contract.

(5)

(a) State funding for supplemental payments authorized in this rule is limited to and obtained through intergovernmental transfer (IGT) agreements of public funds or other permissible source-of-seed funding from the NSGE that holds the license and is party to the Medicaid contract of the nursing care facility.

(b) The NSGE shall ensure that the funds provided to the Department for the non-federal share, via IGT, meet the requirements of 42 CFR 433 Subpart B.

Notes

Utah Admin. Code R414-505-5

Adopted by Utah State Bulletin Number 2016-17, effective 8/12/2016 Amended by Utah State Bulletin Number 2023-23, effective 11/20/2023