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
06/30/2025	Pending Application - Disability Wraparound Coverage and Dental Services Amendment (PDF, 4.71 MB)	View/Submit Comments
11/22/2024	Pending Application – Traditional Healing Services (PDF, 5.58 MB)	View/Submit Comments
07/27/2023	Pending Application – Chronic Conditions Support (PDF, 5.04 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
11/04/2019	Pending Application - Fallback Plan (PDF, 8.32 MB)	View/Submit Comments

Approved Application(s) and Related Documents

Date	Title
06/25/2025	Monitoring Redesign Overlay Letter (PDF, 8.67 MB)
01/08/2025	Demonstration Approval (PDF, 8.74 MB)

Administrative Record

Date	Title
07/09/2025	CMS Completeness Letter (PDF, 113.89 KB)
07/08/2025	SMI Quarterly Monitoring Report April 2024 – June 2024 (Part A) (XLSX, 658.32 KB)
07/08/2025	SMI Quarterly Monitoring Report April 2024 – June 2024 (Part B) (PDF, 353.51 KB)
06/17/2025	SMI Quarterly Monitoring Report January 2025 - March 2025 (Part A) (XLSX, 662.53 KB)
06/17/2025	SMI Quarterly Monitoring Report January 2025 - March 2025 (Part B) (PDF, 282.64 KB)
06/12/2025	SUD Quarterly Monitoring Report January 2025 – March 2025 (Part A) (XLSX, 536.44 KB)
06/12/2025	SUD Quarterly Monitoring Report January 2025 – March 2025 (Part B) (PDF, 288.43 KB)
06/12/2025	SUD Quarterly Monitoring Report October 2024 – December 2024 (Part A) (XLSX, 76.84 KB)
06/12/2025	SUD Quarterly Monitoring Report October 2024 – December 2024 (Part B) (PDF, 289.68 KB)
05/27/2025	Quarterly Monitoring Report July 2024 – September 2024 (PDF, 1.14 MB)
05/27/2025	Quarterly Monitoring Report October 2024 – December 2024 (PDF, 1.1 MB)
05/08/2025	SUD Quarterly Monitoring Report July 2024 – September 2024 (Part A) (XLSX, 536.1 KB)
05/08/2025	SUD Quarterly Monitoring Report July 2024 – September 2024 (Part B) (PDF, 2.94 MB)
03/25/2025	SMI Quarterly Monitoring Report October 2024 – December 2024 (Part A) (XLSX, 663.06 KB)
03/25/2025	SMI Quarterly Monitoring Report October 2024 – December 2024 (Part B) (PDF, 347.95 KB)
01/14/2025	State Annual Monitoring Report July 2023 – June 2024 (PDF, 1.68 MB)
01/08/2025	Protocol Approval Letter (PDF, 8.61 MB)
12/05/2024	SMI Quarterly Monitoring Report July 2024 – September 2024 (Part A) (XLSX, 657.9 KB)
12/05/2024	SMI Quarterly Monitoring Report July 2024 – September 2024 (Part B) (PDF, 286.3 KB)
12/03/2024	CMS Completeness Letter (PDF, 189.28 KB)
11/04/2024	CMS Approved Summative Evaluation Report (PDF, 4.81 MB)
10/22/2024	SUD Quarterly Monitoring Report April 2024 – June 2024 (Part A) (PDF, 296.2 KB)
10/22/2024	SUD Quarterly Monitoring Report April 2024 – June 2024 (Part B) (XLSX, 76.15 KB)
08/27/2024	Quarterly Monitoring Report January 2024 – March 2024 (PDF, 1.08 MB)
08/01/2024	CMS Approved Amended Evaluation Design (PDF, 1.66 MB)
08/01/2024	Demonstration Approval (PDF, 8.59 MB)
07/26/2024	SMI Quarterly Monitoring Report January 2024 – March 2024 (Part A) (XLSX, 662.5 KB)
07/26/2024	SMI Quarterly Monitoring Report January 2024 – March 2024 (Part B) (PDF, 334.9 KB)
07/25/2024	State Acceptance Letter (PDF, 173.93 KB)
07/02/2024	CMS Amendment Approval (PDF, 2.94 MB)
07/02/2024	CMS Completeness Letter (PDF, 164.27 KB)
07/02/2024	State Application – Health Related Social Needs (PDF, 2.5 MB)	View Comments
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)
02/29/2024	CMS Amendment Approval (PDF, 13.79 MB)
02/28/2024	State Quarterly Report October 2023 – December 2023 (PDF, 900.68 KB)
02/27/2024	CMS Approved Evaluation Design (PDF, 1.63 MB)
02/27/2024	Demonstration Approval (PDF, 8.26 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)
07/27/2023	State Application – Dental Services (PDF, 3.13 MB)	View Comments
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	CMS Amendment Approval (PDF, 2.63 MB)
03/04/2022	State Acceptance Letter (PDF, 168.86 KB)
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)
01/18/2022	Risk Mitigation Approval (PDF, 220.79 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)
12/27/2021	State Application – Medical Respite (PDF, 3.27 MB)	View Comments
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)
07/13/2020	Pending Application - Justice-Involved Individuals (PDF, 6.2 MB)	View Comments
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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