Section R414-511-2 - Definitions(1) "Non-emergent medical condition" means a medical condition that does not meet the criteria of an emergency medical condition under 42 U.S.C. 1395dd (e) of the Emergency Medical Treatment and Active Labor Act.(2) "Non-emergent medical care" means medical care provided in an emergency room for the treatment of a non-emergent medical condition.(3) "Non-emergent medical care" does not mean:(a) medically necessary services to conduct a medical screening examination to determine whether the Medicaid member has an emergent or non-emergent medical condition; and(b) medical care provided to a Medicaid member who, using a prudent layperson standard, reasonably believes they are experiencing an emergency medical condition as defined by 42 U.S.C. 1395dd(e) of the Emergency Medical Treatment and Active Labor Act.(4) "Medicaid member" means a person who enrolls in an ACO in accordance with the department's Choice of Health Care Delivery Program freedom-of-choice waiver under Subsection 1915(b) of the Social Security Act.Utah Admin. Code R414-511-2
Amended by Utah State Bulletin Number 2024-04, effective 2/12/2024