§ 26B-3-227 — Recreational therapy -- Reimbursement.

(1) As used in this section:

(1)(a) "Assisted living facility" means the same as that term is defined in Section 26B-2-201.
(1)(b) "Behavioral health program" means a behavioral health program described in Title 62A, Chapter 15, Substance Abuse and Mental Health Act.
(1)(c) "General acute hospital" means the same as that term is defined in Section 26B-2-201.
(1)(d) "Intermediate care facility" means the same as that term is defined in Section 58-15-101.
(1)(e) "Mental health therapist" means the same as that term is defined in Section 58-60-102.
(1)(f) "Qualified enrollee" means an individual who:
(1)(f)(i) is enrolled in the Medicaid program; and
(1)(f)(ii) has been referred for recreational therapy services by a mental health therapist.
(1)(g) "Recreational therapy services" means the same as that term is defined in Section 58-40-102.
(1)(h) "Skilled nursing facility" means the same as that term is defined in Section 58-15-101.
(1)(i) "Youth residential treatment facility" means a facility that provides a 24-hour group living environment for four or more individuals who are under 18 years old and who are unrelated to the owner or provider of the facility.
(2) Before January 1, 2024, the department shall apply for a Medicaid waiver or a state plan with CMS to allow for reimbursement for recreational therapy services provided:

(2)(a) to a qualified enrollee;
(2)(b) by an individual authorized to engage in the practice of recreational therapy under Title 58, Chapter 40, Recreational Therapy Practice Act; and
(2)(c) at a:
(2)(c)(i) general acute hospital;
(2)(c)(ii) youth residential treatment facility;
(2)(c)(iii) behavioral health program;
(2)(c)(iv) intermediate care facility;
(2)(c)(v) assisted living facility;
(2)(c)(vi) skilled nursing facility;
(2)(c)(vii) psychiatric hospital; or
(2)(c)(viii) mental health agency.
(3) If the waiver or state plan amendment described in Subsection (2) is approved, the Medicaid program shall provide coverage to a qualified enrollee for recreational therapy services.

Legislative History

Enacted by Chapter 288, 2023 General Session