Utah Section 1115 Demonstration Application Per Capita Cap (2019)

“With this application, the State is seeking approval to implement the following new proposals for its Medicaid expansion as directed by Senate Bill 96:

• Authority to receive the increased Federal Medical Assistance Percentages (FMAP) allowable under 42 U.S.C. Section 1396d(y) for the Adult Expansion demonstration group, which will include the Targeted Adult demonstration group, as well as any components approved for this population
• A per capita cap funding mechanism
• Lock out from the Medicaid expansion for committing an Intentional Program Violation
• Federal expenditure authority to provide housing related services and supports
• Up to 12-months continuous Medicaid eligibility
• Not allow hospitals to make presumptive eligibility determinations for the Adult Expansion demonstration group
• Additional flexibility for providing managed care”