Section 26B-3-707 - Medicaid hospital adjustment under Medicaid accountable care organization rates(1) To preserve and improve access to hospital services, the division shall incorporate into the Medicaid accountable care organization rate structure calculation consistent with the certified actuarial rate range:(a) $154,000,000 to be allocated toward the hospital inpatient directed payments for the Medicaid eligibility categories covered in Utah before January 1, 2019; and(b) an amount equal to the difference between payments made to hospitals by Medicaid accountable care organizations for the Medicaid eligibility categories covered in Utah, based on submitted encounter data, and the maximum amount that could be paid for those services, to be used for directed payments to hospitals for inpatient and outpatient services.(2)(a) To preserve and improve the quality of inpatient and outpatient hospital services authorized under Subsection (1)(b), the division shall amend its quality strategies required by 42 C.F.R. Sec. 438.340 to include quality measures selected from the CMS hospital quality improvement programs.(b) To better address the unique needs of rural and specialty hospitals, the division may adopt different quality standards for rural and specialty hospitals.(c) The division shall make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to adopt the selected quality measures and prescribe penalties for not meeting the quality standards that are established by the division by rule.(d) The division shall apply the same quality measures and penalties under this Subsection (2) to new directed payments made to the University of Utah Hospital and Clinics.Amended by Chapter 284, 2024 General Session ,§ 26, eff. 5/1/2024.Renumbered from § 26-36d-205 and amended by Chapter 306, 2023 General Session ,§ 115, eff. 5/3/2023.Amended by Chapter 495, 2023 General Session ,§ 1, eff. 5/3/2023.Repealed and reenacted by Chapter 455, 2019 General Session ,§ 8, eff. 5/14/2019.Added by Chapter 1, 2018SP3 General Session ,§ 40, eff. 12/3/2018. Affected by 63I-1-226 on 7/1/2024