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UT SB0193

UT SB0193
Medicaid Provider Reimbursement Amendments


summary

Introduced
01/30/2025
In Committee
03/05/2025
Crossed Over
02/20/2025
Passed
Dead
03/07/2025

Introduced Session

2025 General Session

Bill Summary

General Description: This bill provides for an annual increase in Medicaid rates for certain providers.

AI Summary

This bill amends Utah's Medicaid provider reimbursement system by establishing a comprehensive framework for annual budget adjustments and rate increases for various healthcare providers. The bill introduces detailed definitions for multiple healthcare-related terms and creates a mechanism for increasing reimbursement rates based on the state's General Fund growth factor. Specifically, when the General Fund growth factor is at least 100%, the bill mandates incremental increases in per-member-per-month (PMPM) payments for Accountable Care Organizations (ACOs) and behavioral health plans. In fiscal years 2025 and 2026, the bill requires proportional rate increases for professional services, including applied behavior analysis (ABA) services, air ambulance providers, developmental services for people with disabilities (DSPD), private duty nursing, intermediate care facilities, and nursing facilities. Beginning in fiscal year 2028, the bill also ensures continued rate increases for ABA services. The bill is designed to provide financial stability and gradual improvement in reimbursement rates for various Medicaid healthcare providers, with careful consideration of state budgetary constraints and federal payment limits. The bill is set to take effect on May 7, 2025, and includes provisions for coordination with potential related legislation.

Committee Categories

Business and Industry, Health and Social Services

Sponsors (2)

Last Action

Senate/ filed in Senate file for bills not passed (on 03/07/2025)

bill text


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Document Type Source Location
State Bill Page https://le.utah.gov/~2025/bills/static/SB0193.html
House Committee Report SB0193 https://le.utah.gov/Session/2025/comreport/SB193H20.pdf
House Committee Report SB0193 https://le.utah.gov/Session/2025/comreport/SB193H10.pdf
Fiscal Note SB0193S03 https://pf.utleg.gov/public-web/sessions/2025GS/fiscal-notes/SB0193S03.fn.pdf
BillText https://le.utah.gov/Session/2025/bills/introduced/SB0193S03.pdf
Comparison to Sub #2 https://le.utah.gov/Session/2025/bills/introduced/CP%20SB0193S02%20To%20SB0193S03.pdf
Comparison to Sub #1 https://le.utah.gov/Session/2025/bills/introduced/CP%20SB0193S01%20To%20SB0193S03.pdf
Comparison to Sub #0 https://le.utah.gov/Session/2025/bills/introduced/CP%20SB0193%20To%20SB0193S03.pdf
Fiscal Note SB0193S02 https://pf.utleg.gov/public-web/sessions/2025GS/fiscal-notes/SB0193S02.fn.pdf
Senate Committee Report SB0193 https://le.utah.gov/Session/2025/comreport/SB193S10.pdf
BillText https://le.utah.gov/Session/2025/bills/introduced/SB0193S02.pdf
Fiscal Note SB0193S01 https://pf.utleg.gov/public-web/sessions/2025GS/fiscal-notes/SB0193S01.fn.pdf
Comparison to Sub #1 https://le.utah.gov/Session/2025/bills/introduced/CP%20SB0193S01%20To%20SB0193S02.pdf
Comparison to Sub #0 https://le.utah.gov/Session/2025/bills/introduced/CP%20SB0193%20To%20SB0193S02.pdf
Fiscal Note SB0193 https://pf.utleg.gov/public-web/sessions/2025GS/fiscal-notes/SB0193.fn.pdf
BillText https://le.utah.gov/Session/2025/bills/introduced/SB0193S01.pdf
Comparison to Sub #0 https://le.utah.gov/Session/2025/bills/introduced/CP%20SB0193%20To%20SB0193S01.pdf
BillText https://le.utah.gov/Session/2025/bills/introduced/SB0193.pdf
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