Utah Primary Care Network - Fallback Plan

On November 4, 2019, the State of Utah submitted an amendment to their section 1115 demonstration, "Primary Care Network." This amendment requests authority to receive enhanced Federal Medical Assistance Percentage (FMAP) for the Adult Expansion population and cover beneficiaries with incomes up to 133 percent of the federal poverty level (FPL), lock out individuals from the Adult Expansion Population for committing an Intentional Program Violation (IPV), charge premiums to beneficiaries with incomes above 100 percent of the FPL, limit enrollment in the Adult Expansion Population, receive federal authority to provide housing related services and supports, waive hospital presumptive eligibility for the Adult Expansion Population, and receive additional flexibility for providing managed care and cost containment provisions. The federal comment period will be open from November 7, 2019 through December 7, 2019.

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