Utah DHHS (Medicaid) · July 2, 2026 · Primary source
July2026-MIB.pdf
Summary
Utah Medicaid's July 2026 Medicaid Information Bulletin announces a CMS-approved temporary moratorium on new SUD and mental health rehabilitation provider enrollments, effective immediately for an initial six-month period, while Utah conducts compliance reviews and risk assessments of existing providers. Concurrently, ABA and SUD providers are reclassified to High Risk, requiring all existing providers to revalidate within 18 months, with revalidation notices issued in phases beginning September 2026; providers must respond within 60 days or face termination. A broader mid-cycle revalidation initiative applies to all high-risk billing providers under 42 CFR 424.515. Additional items include behavioral health code rate rebase, behavioral health code standardization updates, telehealth modifier requirements effective January 1, 2027, and PT, OT, and SLP ancillary service reclassification to nursing facility per-diem effective July 1, 2026.
What this may mean
The enrollment moratorium blocks new SUD and mental health rehabilitation providers from entering Utah Medicaid FFS, directly limiting market access for new entrants and affecting network adequacy for SUD treatment. All existing ABA and SUD providers must complete High Risk revalidation, including ownership disclosure at the 5% threshold, FBI fingerprint-based criminal background checks, site visits, and a $750 federal enrollment fee, within 60 days of notice or face Medicaid termination. PT, OT, and SLP services in nursing facilities are no longer separately billable and are absorbed into the per-diem rate retroactively from July 1, 2026.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
Related items
- Ohio Medicaid Fraud Control Unit · October 22, 2026Columbus Doctor, Clinic Manager Plead Guilty in $1.6M Medicaid SchemeScore 92
- OIG Enforcement Actions: EMTALA Patient Dumping Settlements · October 3, 2026ECU Health North Hospital Agreed to Pay $200,000 for Allegedly Violating Patient Dumping Statute by Failing to Provide Appropriate Medical Screening ExaminationsScore 92
- Utah DHHS (Medicaid) · October 24, 2026May2026-MIB.pdfScore 90
- Utah DHHS (Medicaid) · October 24, 2026September2026-MIB.pdfScore 85
- California Legislature (healthcare bills) · October 20, 2026CA SB 530: Medi-Cal: time and distance standards.Score 83
- Utah DHHS (Medicaid) · November 3, 2026November2026-MIB.pdf ,Score 78