Hospital reimbursement.

  1. Law
  2. Utah Code
  3. Utah Health Code
  4. Inpatient Hospital Assessment Act
  5. Assessment and Collection
  6. Hospital reimbursement.

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Affected by 63I-1-226 on 7/1/2024

Effective 5/8/2018
26-36b-209. Hospital reimbursement.
  • (1) If the health coverage improvement program, the enhancement waiver program, or the Medicaid waiver expansion is implemented by contracting with a Medicaid accountable care organization, the department shall, to the extent allowed by law, include, in a contract to provide benefits under the health coverage improvement program, the enhancement waiver program, or the Medicaid waiver expansion, a requirement that the Medicaid accountable care organization reimburse hospitals in the accountable care organization's provider network at no less than the Medicaid fee-for-service rate.
  • (2) If the health coverage improvement program, the enhancement waiver program, or the Medicaid waiver expansion is implemented by the department as a fee-for-service program, the department shall reimburse hospitals at no less than the Medicaid fee-for-service rate.
  • (3) Nothing in this section prohibits a Medicaid accountable care organization from paying a rate that exceeds the Medicaid fee-for-service rate.





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