Substantive changes to waiver provisions -- rulemaking requirements -- definition

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53-6-413. Substantive changes to waiver provisions -- rulemaking requirements -- definition. (1) The department may not make a substantive change to the services offered under an approved waiver or to the eligibility requirements or process for waiver participants unless the department:

(a) adopts rules to implement the changes; and

(b) if necessary, submits a waiver amendment to the centers for medicare and medicaid services and receives approval for the change.

(2) (a) For the purposes of this section, "substantive change" means a change that:

(i) reduces, limits, or otherwise establishes caps on the amount or duration of a service; or

(ii) limits a person's ability to access waiver services.

(b) The term includes but is not limited to changes requiring:

(i) preauthorization before a service is provided;

(ii) preauthorization before an individual is placed on the waiting list for services; or

(iii) that services be used within a specific, shorter time period than previously allowed.

History: En. Sec. 1, Ch. 258, L. 2021.


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