H.B. 558 LEGISLATIVE GENERAL COUNSEL 6 Approved for Filing: A. Houston 6 6 02-23-23 12:30 PM 6 H.B. 558 1 MEDICAID DISABILITY COVERAGE AMENDMENTS 2 2023 GENERAL SESSION 3 STATE OF UTAH 4 Chief Sponsor: Melissa G. Ballard 5 Senate Sponsor: ____________ 6 7LONG TITLE 8General Description: 9 This bill addresses Medicaid coverage for children under age 19 with a disability. 10Highlighted Provisions: 11 This bill: 12 <defines terms; and 13 <requires the Department of Health and Human Services to submit a Medicaid state 14plan amendment to provide treatment to qualified enrollees who live at home and 15meet the financial eligibility criteria established in the state plan. 16Money Appropriated in this Bill: 17 None 18Other Special Clauses: 19 None 20Utah Code Sections Affected: 21ENACTS: 22 26-18-430, Utah Code Annotated 1953 23 24Be it enacted by the Legislature of the state of Utah: 25 Section 1. Section 26-18-430 is enacted to read: 26 26-18-430. Medicaid coverage for children under age 19 with a disability. 27 (1) As used in this section: *HB0558* H.B. 558 02-23-23 12:30 PM - 2 - 28 (a) "Existing home and community-based services waiver" means the existing home 29and community-based services waiver in the state described in Section 26-18-410. 30 (b) "Qualified enrollee" means an individual: 31 (i) who is less than 19 years old; 32 (ii) who is not served under an existing home and community-based services waiver; 33 (iii) who, because of a physical, intellectual, or developmental disability, meets the 34level of care criteria for admission to a hospital, nursing facility, or intermediate care facility 35and can receive such care at home; and 36 (iv) for whom the department has determined that providing care at home would cost 37no more than it would cost to provide that care in a setting described in Subsection (1)(b)(iii). 38 (2) Before July 1, 2024, the department shall apply with CMS for a state plan 39amendment to provide treatment to qualified enrollees who live at home and meet the financial 40eligibility criteria established in the state plan. 41 (3) If the state plan amendment described in Subsection (2) is approved, the department 42shall offer a program that provides treatment for qualified enrollees.