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Utah Medicaid Reform 1115 Demonstration (formerly “Utah Primary Care Network”)

State: Utah
Waiver Authority:
1115
Status: Pending

Waiver Dates

Approval: 02/08/2002
Effective: 07/01/2002
Expiration: 06/30/2027

Supporting Documents

Pending Application(s) and Related Documents

Date Title
07/27/2023 Pending Application – Chronic Conditions Support (PDF, 5.04 MB) View/Submit Comments
07/27/2023 Pending Application – Dental Services (PDF, 3.13 MB) View/Submit Comments
07/27/2023 Pending Application – Family Planning Services (PDF, 5.18 MB) View/Submit Comments
05/16/2023 Pending Application – Extended Postpartum Coverage (PDF, 2.03 MB) View/Submit Comments
12/30/2022 Pending Application – Integrated Services (PDF, 2.27 MB) View/Submit Comments
12/30/2022 Pending Application – LTSS for Behaviorally Complex Individuals (PDF, 2.25 MB) View/Submit Comments
12/27/2021 Pending Application - Medical Respite Amendment (PDF, 3.27 MB) View/Submit Comments
07/13/2020 Pending Application - Justice-Involved Individuals (PDF, 6.2 MB) View/Submit Comments
11/04/2019 Pending Application - Fallback Plan (PDF, 8.32 MB) View/Submit Comments

Approved Application(s) and Related Documents

Date Title
02/29/2024 CMS Amendment Approval (PDF, 13.79 MB)
02/27/2024 Demonstration Approval (PDF, 8.26 MB)
01/18/2022 Risk Mitigation Approval (PDF, 220.79 KB)
12/19/2014 Fact Sheet (PDF, 51.36 KB)

Administrative Record

Date Title
05/07/2024 SMI Retrospective Monitoring Report October 2020 - September 2023 (Part A) (XLSX, 7.2 MB)
04/18/2024 SMI Quarterly Monitoring Report October 2023 - December 2023 (Part A) (XLSM, 134.58 KB)
04/18/2024 SMI Quarterly Monitoring Report October 2023 - December 2023 (Part B) (PDF, 307.41 KB)
04/10/2024 SMI Quarterly Monitoring Report April 2023 – June 2023 (Part A) (XLSM, 138.26 KB)
04/10/2024 SMI Quarterly Monitoring Report April 2023 – June 2023 (Part B) (PDF, 303.09 KB)
04/10/2024 SUD Quarterly Monitoring Report July 2022 – September 2022 (Part A) (XLSX, 68.49 KB)
04/10/2024 SUD Quarterly Monitoring Report July 2022 – September 2022 (Part B) (PDF, 3.45 MB)
03/29/2024 State Acceptance Letter (PDF, 137.5 KB)
02/27/2024 CMS Approved Evaluation Design (PDF, 1.63 MB)
02/21/2024 SMI Quarterly Monitoring Report July 2023 – September 2023 (Part A) (XLSM, 142.07 KB)
02/21/2024 SMI Quarterly Monitoring Report July 2023 – September 2023 (Part B) (PDF, 312.5 KB)
02/21/2024 SUD Quarterly Monitoring Report July 2023 – September 2023 (Part A) (XLSX, 67.98 KB)
02/21/2024 SUD Quarterly Monitoring Report July 2023 – September 2023 (Part B) (PDF, 2.74 MB)
02/12/2024 SUD Quarterly Monitoring Report April 2023 – June 2023 (Part A) (XLSX, 68.48 KB)
02/12/2024 SUD Quarterly Monitoring Report April 2023 – June 2023 (Part B) (PDF, 3.02 MB)
01/22/2024 SUD Quarterly Monitoring Report April 2022 – June 2022 (Part A) (XLSX, 143.15 KB)
01/22/2024 SUD Quarterly Monitoring Report April 2022 – June 2022 (Part B) (PDF, 2.74 MB)
01/22/2024 SUD Quarterly Monitoring Report October 2022 – December 2022 (Part A) (XLSX, 68.11 KB)
01/22/2024 SUD Quarterly Monitoring Report October 2022 – December 2022 (Part B) (PDF, 3.51 MB)
01/17/2024 SMI Quarterly Monitoring Report January 2023 - March 2023 (Part B) (PDF, 281.44 KB)
01/17/2024 SUD Quarterly Monitoring Report January 2023 - March 2023 (Part B) (PDF, 2.75 MB)
01/05/2024 SMI Quarterly Monitoring Report January 2022 - March 2022 (Part A) (XLSM, 134.26 KB)
01/05/2024 SMI Quarterly Monitoring Report January 2022 - March 2022 (Part B) (PDF, 272.33 KB)
12/01/2023 SMI Quarterly Monitoring Report July 2022 – September 2022 (Part A) (XLSM, 132.89 KB)
12/01/2023 SMI Quarterly Monitoring Report July 2022 – September 2022 (Part B) (PDF, 326.32 KB)
11/28/2023 SMI Quarterly Monitoring Report October 2022 – December 2022 (Part A) (XLSM, 131.45 KB)
11/28/2023 SMI Quarterly Monitoring Report October 2022 – December 2022 (Part B) (PDF, 304.78 KB)
11/28/2023 State Quarterly Report July 2023 – September 2023 (PDF, 918.62 KB)
10/06/2023 SMI Quarterly Monitoring Report April 2022 - June 2022 Part A (XLSM, 136.06 KB)
10/06/2023 SMI Quarterly Monitoring Report April 2022 - June 2022 Part B (PDF, 314.05 KB)
09/28/2023 State Annual Report July 2022 – June 2023 (PDF, 1.02 MB)
09/08/2023 CMS Letter to State (PDF, 211.59 KB)
08/02/2023 CMS Completeness Letter (PDF, 232.82 KB)
06/01/2023 CMS Completeness Letter (PDF, 233.12 KB)
05/30/2023 State Quarterly Report – January 2023 – March 2023 (PDF, 837.54 KB)
05/24/2023 CMS Approved Risk Mitigation Amendment Evaluation Design (PDF, 565.23 KB)
05/18/2023 CMS Approved SMI Monitoring Protocol (Part A) (XLSX, 85.84 KB)
05/18/2023 CMS Approved SMI Monitoring Protocol (Part B) (PDF, 389.34 KB)
05/18/2023 CMS Approved SUD Monitoring Protocol (Part A) (XLSX, 144.26 KB)
05/18/2023 CMS Approved SUD Monitoring Protocol (Part B) (PDF, 1009.9 KB)
05/18/2023 Demonstration Approval - SUD and SMI Monitoring Protocols (PDF, 7.89 MB)
04/19/2023 CMS Completeness Letter (PDF, 232.39 KB)
04/10/2023 Application - UPP Premium Increase (PDF, 2.57 MB) View Comments
03/09/2023 SMI Quarterly Report October 2021 – December 2021 Part A (XLSM, 136.78 KB)
03/09/2023 SMI Quarterly Report October 2021 – December 2021 Part B (PDF, 269.15 KB)
03/09/2023 SMI Retrospective Monitoring Report April 2021 – September 2021 (XLSX, 93.12 KB)
02/24/2023 State Quarterly Report – October 2022 – December 2022 (PDF, 996.34 KB)
01/30/2023 State Annual Report July 2021 – June 2022 (PDF, 5.87 MB)
01/12/2023 CMS Completeness Letter (PDF, 337.85 KB)
11/29/2022 State Quarterly Report July – September 2022 (PDF, 717.91 KB)
11/15/2022 CMS Accepted Interim Evaluation Reports (PDF, 4.35 MB)
09/28/2022 SUD Mid-Point Assessment (PDF, 3.17 MB)
09/01/2022 CMS Approved PCN-TAM-CE-BDD-UPP Evaluation Design (PDF, 705.24 KB)
09/01/2022 CMS Approved SMI-AD-ISS Evaluation Designs (PDF, 2.61 MB)
08/29/2022 State Quarterly Report January – March 2022 (PDF, 601.23 KB)
07/29/2022 SUD Quarterly Report January 2022 – March 2022 (Part A) (XLSX, 152.36 KB)
07/29/2022 SUD Quarterly Report January 2022 – March 2022 (Part B) (PDF, 2.74 MB)
07/11/2022 State Acceptance Letter (PDF, 233.2 KB)
06/30/2022 Demonstration Approval (PDF, 2.69 MB)
03/04/2022 State Acceptance Letter (PDF, 168.86 KB)
03/04/2022 CMS Amendment Approval (PDF, 2.63 MB)
03/01/2022 SUD Quarterly Report October – December 2021 (Part A) (XLSX, 142.84 KB)
03/01/2022 SUD Quarterly Report October – December 2021 (Part B) (PDF, 3.43 MB)
02/28/2022 State Quarterly Report October – December 2021 (PDF, 849.55 KB)
02/22/2022 State Acceptance of Managed Care Risk Mitigation COVID-19 Amendment (PDF, 179.12 KB)
02/14/2022 SMI Quarterly Report January- March 2021 (PDF, 268.69 KB)
12/27/2021 Application - Fertility Preservation Amendment (PDF, 3.28 MB) View Comments
12/27/2021 CMS Completeness Letter - Fertility Preservation Amendment (PDF, 152.9 KB)
12/27/2021 CMS Completeness Letter - Medical Respite Amendment (PDF, 152.89 KB)
12/20/2021 SUD Quarterly Monitoring Report Revised Metrics November 2017 – March 2021 (XLSX, 102.77 KB)
12/13/2021 SUD Quarterly Report July- September 2021 (PDF, 3.34 MB)
12/13/2021 SUD Quarterly Report July- September 2021 (XLSX, 143.71 KB)
12/07/2021 CMS Approved SMI Monitoring Protocol (Part A) (XLSX, 88.72 KB)
12/07/2021 CMS Approved SMI Monitoring Protocol (Part B) (PDF, 323.15 KB)
12/07/2021 Serious Mental Illness (SMI) Monitoring Protocol Approval (PDF, 8.2 MB)
12/03/2021 State Quarterly Report July – September 2021 (PDF, 674.33 KB)
11/30/2021 SMI Quarterly Report July – September 2021 (PDF, 271.66 KB)
11/29/2021 CMS Approved UMIC Evaluation Design (PDF, 1.68 MB)
11/29/2021 Medicaid Integrated Care Evaluation Design Approval (PDF, 4.2 MB)
10/25/2021 CMS Approved SUD Evaluation Design (Updated) (PDF, 636.63 KB)
10/22/2021 SMI Annual Report January – June 2021 (PDF, 277.51 KB)
09/29/2021 SUD Annual Report July 2020 – June 2021 (PDF, 2.76 MB)
09/29/2021 SUD Annual Report July 2020 – June 2021 (XLSX, 143.07 KB)
09/28/2021 State Annual Report July 2020 – June 2021 (PDF, 731.29 KB)
09/17/2021 CMS Completeness Letter (PDF, 156.23 KB)
09/17/2021 State Extension Request (PDF, 48.34 MB) View Comments
08/10/2021 CMS Letter to State (PDF, 2.21 MB)
07/26/2021 SUD Quarterly Monitoring Report October 2020 – December 2020 (Part A) (XLSX, 142.73 KB)
07/26/2021 SUD Quarterly Monitoring Report October 2020 – December 2020 (Part B) (PDF, 2.74 MB)
07/23/2021 CMS Approval (PDF, 3.67 MB)
07/23/2021 State Acceptance Letter (PDF, 191.69 KB)
07/16/2021 Utah Demonstration Extension Request Incomplete Letter (PDF, 211.15 KB)
05/28/2021 SUD Quarterly Report January – March 2021 (PDF, 3.33 MB)
05/28/2021 SUD Quarterly Report January – March 2021 (XLSX, 142.71 KB)
05/28/2021 State Quarterly Report January – March 2021 (PDF, 629.55 KB)
05/17/2021 Quarterly SUD Monitoring Reports (with retro data) November 2017 – September 2020 (ZIP, 1.57 MB)
05/10/2021 Clinically Managed Residential Withdrawal Services Pilot Phase-out Letter (PDF, 965.42 KB)
03/12/2021 Letter from State (PDF, 134.54 KB)
03/04/2021 CMS Completeness Letter - UPP Amendment (PDF, 417.69 KB)
03/02/2021 SMI Quarterly Report October – December 2021 (PDF, 386.12 KB)
03/02/2021 State Quarterly Report October – December 2020 (, 229.99 KB)
02/19/2021 Application - UPP Amendment (PDF, 6.47 MB) View Comments
02/12/2021 CMS Letter to State (PDF, 38.59 KB)
02/12/2021 CMS Letter to State about Demonstration (PDF, 312.92 KB)
02/01/2021 State Acceptance Letter (PDF, 180.49 KB)
01/19/2021 Letter from State - Rescinded (PDF, 1.47 MB)
01/13/2021 CMS Completeness Letter - IVF and Genetic Testing Amendment (PDF, 116.16 KB)
12/30/2020 Application - IVF and Genetic Testing Amendment (PDF, 9.88 MB) View Comments
12/16/2020 CMS Approved SMI Implementation Plan (PDF, 780.03 KB)
12/16/2020 Demonstration Approval (PDF, 3.1 MB)
12/04/2020 State Quarterly Report July – September 2020 (PDF, 991.03 KB)
11/30/2020 CMS Approved Evaluation Designs – CE-TAMD-MW-AE-ESI (PDF, 1.45 MB)
10/09/2020 August 2017 PCN Amendments Withdrawal Letter (PDF, 248.66 KB)
09/30/2020 Annual Report July 2019-June 2020 (PDF, 1.06 MB)
09/24/2020 CMS Completeness Letter (PDF, 247.85 KB)
09/08/2020 Dental Amendment Request (PDF, 3.6 MB) View Comments
08/28/2020 CMS Approved SUD Monitoring Protocol (Part A) (XLSX, 140.13 KB)
08/28/2020 CMS Approved SUD Monitoring Protocol (Part B) (PDF, 351.92 KB)
08/28/2020 CMS SUD Monitoring Protocol Approval (PDF, 2.93 MB)
08/17/2020 CMS Complete Letter (PDF, 423.64 KB)
08/04/2020 Behavioral Health Services/IMD Amendment Request (PDF, 3.69 MB) View Comments
07/17/2020 CMS Approval - STC Attachment Update (PDF, 910.19 KB)
07/10/2020 CMS Complete Letter (PDF, 253.24 KB)
05/29/2020 Quarterly Report January-March 2020 (PDF, 1.01 MB)
03/09/2020 Quarterly Report October-December 2019 (PDF, 998.29 KB)
12/24/2019 Intensive Stabilization Services Amendment Acceptance Letter (PDF, 963 KB)
12/23/2019 CMS Amendment Approval – Adult Expansion Population / Dental Benefits / Targeted Adults (PDF, 2.51 MB)
12/03/2019 Quarterly Report July-September 2019 (PDF, 698.7 KB)
11/25/2019 Intensive Stabilization Services Amendment Approval (PDF, 1.92 MB)
11/07/2019 CMS Complete Letter – Fallback Amendment (PDF, 961.09 KB)
10/16/2019 SUD Evaluation Design Approval (PDF, 882.7 KB)
10/07/2019 Annual Report July 2018 – June 2019 (PDF, 433.85 KB)
09/11/2019 CMS Complete Letter – Integrated Care Amendment (PDF, 934.79 KB)
08/29/2019 Integrated Care Amendment Application (PDF, 2.27 MB) View Comments
07/11/2019 CMS Complete Letter – Dental Amendment (PDF, 925.41 KB)
06/28/2019 Aged Population Dental Amendment Application (PDF, 9.26 MB) View Comments
06/06/2019 Quarterly Report January-March 2019 (PDF, 489.23 KB)
06/05/2019 May 27, 2019 Family Planning Amendment Withdrawal Letter (PDF, 3.08 MB)
04/26/2019 April 26, 2019 State Acceptance Letter (PDF, 1.27 MB)
03/29/2019 Community Engagement Amendment Approval (PDF, 975.52 KB)
03/06/2019 Quarterly Report October-December 2018 (PDF, 400.79 KB)
02/28/2019 SUD Dental Amendment Acceptance Letter (PDF, 967.83 KB)
02/08/2019 Social Detoxification Amendment CMS Completeness Determination Letter (PDF, 182.38 KB)
02/06/2019 State Social Detoxification Amendment Application (PDF, 9.75 MB) View Comments
02/01/2019 SUD Dental Amendment Approval (PDF, 999.97 KB)
12/05/2018 Quarterly Report July-September 2018 (PDF, 340.51 KB)
10/11/2018 Annual Report July 2017-June 2018 (PDF, 308.14 KB)
08/10/2018 Draft Evaluation Design (PDF, 577.61 KB)
07/12/2018 CMS Completeness Letter (PDF, 117.67 KB)
07/05/2018 CMS Completeness Letter (PDF, 117.26 KB)
06/29/2018 Amendment Request (PDF, 7.66 MB) View Comments
06/21/2018 State June 2018 Amendment Application (PDF, 6.55 MB) View Comments
05/31/2018 Quarterly Report January-March 2018 (PDF, 345.08 KB)
03/29/2018 DY16 Q2 Monitoring Report October-December 2017 (PDF, 934.3 KB)
11/30/2017 UT PCN Extension State Acceptance Letter (PDF, 1.12 MB)
11/09/2017 UT PCN SUD Implementation Protocol Approval (11/09/2017) (PDF, 326.07 KB)
10/31/2017 CMS Extension Approval (PDF, 582.3 KB)
08/30/2017 UT PCN Amendment CMS Completeness Determination (08/30/17) (PDF, 124.41 KB)
08/15/2017 August 2017 Amendment Request - Withdrawn (PDF, 2.82 MB) View Comments
07/26/2017 Dental Benefits for Blind and Disabled Individuals Amendment Acceptance Letter (PDF, 957.64 KB)
06/29/2017 Dental Benefits for Blind and Disabled Individuals Amendment Approval (PDF, 479.5 KB)
02/17/2017 Dental Benefits for Blind and Disabled Individuals Amendment Completeness Determination (PDF, 110.15 KB)
02/01/2017 Dental Benefits for Blind and Disabled Individuals Amendment Request (PDF, 1.96 MB) View Comments
12/16/2016 Demonstration Approval (12/16/2016) (PDF, 432 KB)
08/19/2016 CMS Complete Letter (08/19/2016) (PDF, 65.03 KB)
08/19/2016 State Application – 2016 extension Application (PDF, 11.13 MB) View Comments
07/15/2016 CMS Incomplete Letter (07/15/2016) (PDF, 33.4 KB)
01/12/2016 CMS Completeness Letter (01/12/2016) (PDF, 91.84 KB)
11/19/2015 Temporary Extension Letter (11/19/2015) (PDF, 90.73 KB)
07/09/2015 CMS Incomplete Letter (07/09/2015) (PDF, 484.08 KB)
06/26/2015 1-Year Extension Application (06/26/15) (PDF, 14.81 MB) View Comments
12/23/2014 Coverage Application Letter (12/23/2014) (PDF, 100.78 KB)
12/19/2014 Demonstration Approval (12/19/2014) (PDF, 463.18 KB)
12/24/2013 Temporary Extension Letter (12/24/2013) (PDF, 103.6 KB)
11/14/2013 Approval of Temporary Extension Letter (11/14/13) (PDF, 81.24 KB)
07/01/2013 1115 Demo Waiver (07/01/13-06/30/13) (PDF, 8.5 MB)
07/01/2013 1115 Demo Waiver (07/01/13-06/30/16) (PDF, 8.5 MB)
01/14/2013 Approval of Extension Request Letter (01/14/13) (PDF, 102.47 KB)
12/19/2012 Request for Extension Letter (12/19/12) (PDF, 50.94 KB)
12/19/2012 Request for Extension Letter (12/19/12) (PDF, 102.47 KB)
09/28/2012 Approval to Amend Letter (09/28/12) (PDF, 54.75 KB)
07/01/2010 Special Terms and Conditions (07/01/10-06/30/13) (PDF, 267.13 KB)
07/01/2010 Waiver List (07/01/10-06/30/13) (PDF, 22.86 KB)
Matchable Authorities (PDF, 28.71 KB)
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