Section R414-515-4 - Program Access Requirements(1)(a) A member must meet the severity of illness and intensity of service for LTAC hospital level -of -care as determined through an evidence-based criteria review process.(b) The Department shall deny an LTAC request for reimbursement if the member does not meet the evidence-based criteria.(2) The Department may forward LTAC preadmissions, continued stays, and retroactive stays that do not meet the evidence-based criteria for secondary medical review if:(a) the LTAC provider requests the secondary medical review; or(b) review of documentation shows that LTAC is the most appropriate level -of -care for the member.Utah Admin. Code R414-515-4
Adopted by Utah State Bulletin Number 2018-1, effective 12/12/2017Amended by Utah State Bulletin Number 2019-8, effective 3/21/2019Amended by Utah State Bulletin Number 2023-22, effective 11/1/2023