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Utah Primary Care Network

State: Utah
Waiver Authority:
1115
Status: Pending

Waiver Dates

Approval: 02/08/2002
Effective: 07/01/2002
Expiration: 06/30/2022

Supporting Documents

Pending Application(s) and Related Documents

Date Title
Date   12/27/2021 Title   Pending Application - Fertility Preservation Amendment (PDF, 3.28 MB) View/Submit Comments
Date   12/27/2021 Title   Pending Application - Medical Respite Amendment (PDF, 3.27 MB) View/Submit Comments
Date   09/17/2021 Title   Pending Application - Extension Request (PDF, 48.34 MB) View/Submit Comments
Date   12/30/2020 Title   Pending Application - IVF and Genetic Testing Amendment (PDF, 9.88 MB) View/Submit Comments
Date   07/13/2020 Title   Pending Application - Justice-Involved Individuals (PDF, 6.2 MB) View/Submit Comments
Date   11/04/2019 Title   Pending Application - Fallback Plan (PDF, 8.32 MB) View/Submit Comments

Approved Application(s) and Related Documents

Date Title
Date   03/04/2022 Title   Demonstration Approval (PDF, 2.63 MB)
Date   01/18/2022 Title   Risk Mitigation Approval (PDF, 220.79 KB)
Date   12/19/2014 Title   Fact Sheet (PDF, 51.36 KB)

Administrative Record

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