ut-20260915-R414-11: R414-11. Podiatric Services

1. Agency Information

Title catchline: Health and Human Services, Integrated Healthcare Building: Cannon Health Building Street address: 288 N 1460 W City, state: Salt Lake City, UT Mailing address: PO Box 143325 City, state and zip: Salt Lake City, UT 84114-3325

2. Contact Persons

Name: Phone: Email: Craig Devashrayee 801-915-4493 cdevashrayee@utah.gov Mariah Noble 385-214-1150 mariahnoble@utah.gov Please address questions regarding information on this notice to the persons listed above.

B. Purpose of the new rule or reason for the change:

Based on discussions within the Division of Integrated Healthcare (division), it was determined that this amendment is appropriate to implement by rule existing Medicaid policy regarding services and payment for podiatric services that are currently being implemented through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual. UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 93 NOTICES OF PROPOSED RULES

C. Summary of the new rule or change:

This amendment implements, by rule, Medicaid policy for podiatric services that includes requirements for eligibility, requirements for program access, service coverage, and reimbursement. 5. Fiscal Information Provide an estimate and written explanation of the aggregate anticipated cost or savings to:

A. State budget:

The Department of Health and Human Services (department) does not expect a fiscal impact to the state budget as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual. Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.

B. Local governments:

The department does not expect a fiscal impact to local governments as they neither fund nor provide podiatric services under the Medicaid program.

C. Small businesses ("small business" means a business employing 1-49 persons):

The department does not expect a fiscal impact to small businesses as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual. Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.

D. Non-small businesses ("non-small business" means a business employing 50 or more persons):

The department does not expect a fiscal impact to non-small businesses as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual. Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes. E. Persons other than small businesses, non-small businesses, state, or local government entities ("person" means any individual, partnership, corporation, association, governmental entity, or public or private organization of any character other than an agency): The department does not expect a fiscal impact to Medicaid members or entities outside of government or business as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual. Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes.

F. Compliance costs for affected persons:

The department does not expect any compliance costs for affected persons, including the state, a small or non-small business, a Medicaid member, or a single entity outside of government or business, as the department already implements this policy through the Medicaid State Plan and the Physician Services Utah Medicaid Provider Manual. Procedures for implementing these provisions are already in place, and this filing does not add to, modify, or remove any associated processes. 94 UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 NOTICES OF PROPOSED RULES 6. Regulatory Impact Summary Table Enter the cost or savings in the relevant cell. If there is no cost or savings, enter, "$0." If a cost or savings is inestimable, enter, "inestimable." Fiscal Cost FY2027 FY2028 FY2029 FY2030 FY2031 State Budget $0 $0 $0 $0 $0 Local Governments $0 $0 $0 $0 $0 Small Businesses $0 $0 $0 $0 $0 Non-Small Businesses $0 $0 $0 $0 $0 Other Persons $0 $0 $0 $0 $0 Total Fiscal Cost $ $ $ $ $ Fiscal Benefits FY2027 FY2028 FY2029 FY2030 FY2031 State Budget $0 $0 $0 $0 $0 Local Governments $0 $0 $0 $0 $0 Small Businesses $0 $0 $0 $0 $0 Non-Small Businesses $0 $0 $0 $0 $0 Other Persons $0 $0 $0 $0 $0 Total Fiscal Benefits $0 $0 $0 $0 $0 Net Fiscal Benefits $0 $0 $0 $0 $0 7. Regulatory Impact Analysis Approval The Commissioner of the Department of Health and Human Services, Tracy S. Gruber, has reviewed and approved this regulatory impact analysis. 8. Family Impact Information

A. The agency has considered this rule's impact on family health, stability, and formation:

☒ 9. Citation Information Provide citations to the statutory authority for the rule. If there is also a federal requirement for the rule, provide a citation to that requirement: Section 26B-1-213 Section 26B-3-108 11. Public Notice Information The public may submit written or oral comments to the agency identified in box 1.

A. Comments will be accepted until: 10/15/2026

12. Effective Date Information This rule change MAY become effective on: 10/22/2026 (NOTE: This is the date the agency anticipates making the filing effective. It is NOT the effective date) 13. Agency Authorization Information Agency head or Tracy S. Gruber, Commissioner Date: 08/28/2026 designee and title: R414. Health and Human Services, Integrated Healthcare. R414-11. Podiatric Services. R414-11-1. [Introduction]Authority and Purpose. [The Podiatric Services program provides a scope of services for Medicaid recipients in accordance with the Podiatric Services Utah Medicaid Provider Manual andAttachment 4.19-B of the Medicaid State Plan, as incorporated into Section R414-1-5.](1)(a) Sections 26B-1- 213 and 26B-3-108 authorize this rule. (b) 42 CFR 440.60 (2026) andAttachments 3.1-A, 3.1-B, and 4.19-B of the Utah Medicaid State Plan authorize podiatric services. (2) This rule outlines eligibility, access requirements, coverage, limitations, and reimbursement for podiatric services. UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 95 NOTICES OF PROPOSED RULES R414-11-2. Definitions. "Podiatric services" means, in accordance with Section 58-5a-102, the examination, diagnosis, or treatment medically, mechanically, or surgically of an ailment of the human foot. R414-11-3. Member Eligibility Requirements. To be eligible for podiatric services, an individual must be an eligible Medicaid member. R414-11-4. ProgramAccess Requirements. (1) An eligible Medicaid member may only obtain podiatric services from a provider enrolled with Medicaid. (2) Aqualified healthcare professional, acting within the professional's scope of practice, may provide podiatric services. R414-11-5. Service Coverage. The podiatric services program provides a scope of services for Medicaid members in accordance with the Physician Services Utah Medicaid Provider Manual. R414-11-6. Reimbursement Methodology. Reimbursement for podiatric services shall be in accordance withAttachment 4.19-B of the Utah Medicaid State Plan. KEY: Medicaid Date of Last Change: [November 10, 2023]2026 Notice of Continuation: November 7, 2023 Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108 NOTICE OF SUBSTANTIVE CHANGE TYPE OF FILING: New Filing ID: 58205