Healthcare (Long-Term Care)

HB 506 amends Utah's assisted living facility regulations to protect residents by limiting when facilities can discharge or transfer them and creating a formal appeals process. It requires facilities to provide written notice of discharge/transfers, allows residents or their representatives to appeal to the state department within 30 days, and prohibits discharge during an appeal unless health/safety is at immediate risk. The bill specifies five allowable reasons for discharge (e.g., facility closure, resident safety threat, or failure to pay) and mandates a hearing within 30 days (or 7 days for expedited requests) before a decision is made. These changes directly affect assisted living residents and their representatives, ensuring greater transparency and due process in facility decisions.

SB 319 requires Utah health insurance companies to increase transparency around preauthorization processes. It mandates insurers to post detailed preauthorization requirements and statistics on their websites, disclose if they use artificial intelligence in reviews, and make decisions within seven days. The bill also sets minimum validity periods for authorizations covering chronic or long-term care conditions and requires independent medical judgment for denials. These changes directly affect insurers, healthcare providers submitting requests, and patients seeking covered services.

SB 158 expands Medicaid reimbursement eligibility to include licensed residential support programs accredited by the American Camp Association, directly affecting Medicaid beneficiaries receiving recreational therapy services in these facilities. The bill adds this program type to the existing list of covered settings (like hospitals and skilled nursing facilities) where qualified enrollees - those enrolled in Medicaid and referred by a mental health therapist - can access reimbursed services. It authorizes the Department of Health and Human Services to seek necessary federal waivers to implement this change, with no new state funding required. The policy takes effect May 6, 2026, and focuses solely on expanding coverage eligibility without altering service criteria or beneficiary requirements.

HB 343 amends Utah's Medicaid certification rules for nursing care facilities, primarily affecting facilities seeking to renew or transfer certification when relocating or renovating. The key change allows facilities with a previously approved two-year extension for relocation to request a longer four-year extension under specific circumstances, such as emergencies or documented need. It also clarifies requirements for maintaining certification during facility transitions, including written assurances to avoid disputes over facility ownership. The bill makes technical updates to existing code but does not appropriate new funds or change bed capacity rules without director approval. This streamlines certification continuity for facilities relocating within counties or within five miles of their original site.