26-40-106 - Program benefits. - Utah Statutes

26-40-106. Program benefits.
(1) Until the department implements a plan under Subsection (2), program benefits mayinclude:
(a) hospital services;
(b) physician services;
(c) laboratory services;
(d) prescription drugs;
(e) mental health services;
(f) basic dental services;
(g) preventive care including:
(i) routine physical examinations;
(ii) immunizations;
(iii) basic vision services; and
(iv) basic hearing services;
(h) limited home health and durable medical equipment services; and
(i) hospice care.
(2) (a) Except as provided in Subsection (2)(c), no later than July 1, 2008, the programbenefits shall be benchmarked, in accordance with 42 U.S.C. 1397cc, to be actuarially equivalentto a benefit plan with the largest insured commercial enrollment offered by a health maintenanceorganization in the state.
(b) Except as provided in Subsection (2)(c), after July 1, 2008:
(i) program benefits may not exceed the benefit level described in Subsection (2)(a); and
(ii) program benefits shall be adjusted every July 1, thereafter to meet the benefit leveldescribed in Subsection (2)(a).
(c) The program benefits for enrollees who are at or below 100% of the federal povertylevel are exempt from the benchmark requirements of Subsections (2)(a) and (2)(b).

Amended by Chapter 47, 2007 General Session