NOTICE OF SUBSTANTIVE CHANGE
TYPE OF FILING: Amendment
1. Agency Information
Health and Human Services, Integrated Healthcare
Salt Lake City, UT 84114-3325
2. Contact Persons
Please address questions regarding information on this notice to the persons listed above.
3. General Information
A. Rule or section catchline:
R414-11. Podiatric Services
B. Purpose of the new rule or reason for the change:
Based on discussions within the Division of Integrated Healthcare (division), it was determined that this amendment is appropriate to implement by rule existing Medicaid policy regarding services and payment for podiatric services that are currently being implemented through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual.
C. Summary of the new rule or change:
This amendment implements, by rule, Medicaid policy for podiatric services that includes requirements for eligibility, requirements for program access, service coverage, and reimbursement.
5. Fiscal Information
Provide an estimate and written explanation of the aggregate anticipated cost or savings to:
The Department of Health and Human Services (department) does not expect a fiscal impact to the state budget as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual.
Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.
The department does not expect a fiscal impact to local governments as they neither fund nor provide podiatric services under the Medicaid program.
C. Small businesses ("small business" means a business employing 1-49 persons):
The department does not expect a fiscal impact to small businesses as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual.
Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.
D. Non-small businesses ("non-small business" means a business employing 50 or more persons):
The department does not expect a fiscal impact to non-small businesses as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual.
Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.
E. Persons other than small businesses, non-small businesses, state, or local government entities ("person" means any individual, partnership, corporation, association, governmental entity, or public or private organization of any character other than an agency):
The department does not expect a fiscal impact to Medicaid members or entities outside of government or business as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual.
Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.
F. Compliance costs for affected persons:
The department does not expect any compliance costs for affected persons, including the state, a small or non-small business, a Medicaid member, or a single entity outside of government or business, as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual.
Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.
6. Regulatory Impact Summary Table
Enter the cost or savings in the relevant cell. If there is no cost or savings, enter, "$0." If a cost or savings is inestimable, enter, "inestimable."
7. Regulatory Impact Analysis Approval
The Commissioner of the Department of Health and Human Services, Tracy S. Gruber, has reviewed and approved this regulatory impact analysis.
8. Family Impact Information
A. The agency has considered this rule's impact on family health, stability, and formation:
9. Citation Information
Provide citations to the statutory authority for the rule. If there is also a federal requirement for the rule, provide a citation to that requirement:
11. Public Notice Information
The public may submit written or oral comments to the agency identified in box 1.
A. Comments will be accepted until:
12. Effective Date Information
This rule change MAY become effective on:
(NOTE: This is the date the agency anticipates making the filing effective. It is NOT the effective date)
13. Agency Authorization Information
Tracy S. Gruber, Commissioner
R414. Health and Human Services, Integrated Healthcare.
R414-11. Podiatric Services.
R414-11-1. [Introduction]Authority and Purpose. [The Podiatric Services program provides a scope of services for Medicaid recipients in accordance with the Podiatric Services Utah Medicaid Provider Manual and Attachment 4.19-B of the Medicaid State Plan, as incorporated into Section R414-1-5.](1)(a) Sections 26B-1-213 and 26B-3-108 authorize this rule. (b) 42 CFR 440.60 (2026) and Attachments 3.1-A, 3.1-B, and 4.19-B of the Utah Medicaid State Plan authorize podiatric services. (2) This rule outlines eligibility, access requirements, coverage, limitations, and reimbursement for podiatric services. "Podiatric services" means, in accordance with Section 58-5a-102, the examination, diagnosis, or treatment medically, mechanically, or surgically of an ailment of the human foot. R414-11-3. Member Eligibility Requirements. To be eligible for podiatric services, an individual must be an eligible Medicaid member. R414-11-4. Program Access Requirements. (1) An eligible Medicaid member may only obtain podiatric services from a provider enrolled with Medicaid. (2) A qualified healthcare professional, acting within the professional's scope of practice, may provide podiatric services. R414-11-5. Service Coverage. The podiatric services program provides a scope of services for Medicaid members in accordance with the Physician Services Utah Medicaid Provider Manual. R414-11-6. Reimbursement Methodology. Reimbursement for podiatric services shall be in accordance with Attachment 4.19-B of the Utah Medicaid State Plan. KEY: Medicaid
Date of Last Change: [November 10, 2023]2026 Notice of Continuation: November 7, 2023
Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108
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