Section R414-515-5 - Service Coverage(1) A member must receive prior authorization for preadmission, continued stay, and retroactive reviews.(2) An LTAC provider must submit to the Department a request for coverage that includes current and comprehensive documentation, or the Department will return the request as incomplete.(3) The Department shall consider LTAC coverage upon the date it receives the request with current, comprehensive documentation.(4) The Department shall review the documentation to determine preadmission, continued stay, or retroactive stay within three business days of the request.(5) An LTAC provider may not transfer prior authorization to another L T A C provider.(6) If a member transfers from an LTAC hospital to an acute care hospital for any reason, and is away from the LTAC hospital for more than 24 hours, the LTAC provider shall submit a new preadmission review before transferring the member back to the LTAC hospital.(7) The Department authorizes each approved prior authorization for up to 28 days.Utah Admin. Code R414-515-5
Adopted by Utah State Bulletin Number 2018-1, effective 12/12/2017Amended by Utah State Bulletin Number 2019-8, effective 3/21/2019Amended by Utah State Bulletin Number 2023-22, effective 11/1/2023