Utah Code § 26B-3-510

Hospital reimbursement
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(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.
Renumbered and Amended by Chapter 306, 2023 General Session

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