26B-3-610.  Hospital reimbursement.

(1)  If the qualified Medicaid 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 qualified Medicaid expansion a requirement that the accountable care organization reimburse hospitals in the accountable care organization’s provider network at no less than the Medicaid fee-for-service rate.

Terms Used In Utah Code 26B-3-610

  • Contract: A legal written agreement that becomes binding when signed.
  • Medicaid accountable care organization: means a managed care organization, as defined in 42 C. See Utah Code 26B-3-601
(2)  If the qualified Medicaid 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 the department or a Medicaid accountable care organization from paying a rate that exceeds the Medicaid fee-for-service rate.

Renumbered and Amended by Chapter 306, 2023 General Session