ut-20261015-R414-302-8: R414-302-8. Application for Other Possible Benefits

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.

A. Rule or section catchline:

R414-302-8. Application for Other Possible Benefits

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

This filing implements a change in policy that no longer requires an individual to apply for other financial benefits before applying for Medicaid.

C. Summary of the new rule or change:

This filing implements a change in policy that no longer requires an individual to apply for other financial benefits before applying for Medicaid. It also removes provisions for modified adjustment gross income and Veterans Administration benefits that no longer apply to this rule. 34 UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 NOTICES OF PROPOSED RULES 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) estimates a total cost of about $262,747 based on an increase to the General Fund, its federal match, and an increase to the fund for Medicaid expansion in accordance with the Affordable Care Act. There is no estimated savings to the state budget.

B. Local governments:

There is no expected fiscal impact on local governments as they neither fund nor provide services under the Medicaid program.

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

The department estimates an increase in revenue for small businesses based on an increase in eligibility and coverage for Medicaid members. There is, however, no available data to estimate the number of individuals who will become eligible for Medicaid with the removal of the requirement to apply for other financial benefits, and it is impossible to know how many of those individuals will seek services from small businesses. Therefore, this anticipated increase in revenue is considered inestimable. There is no estimated cost to small businesses.

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

The department estimates an increase in revenue for non-small businesses based on an increase in eligibility and coverage for Medicaid members. There is, however, no available data to estimate the number of individuals who will become eligible for Medicaid with the removal of the requirement to apply for other financial benefits, and it is impossible to know how many of those individuals will seek services from non-small businesses. Therefore, this anticipated increase in revenue is considered inestimable. There is no estimated cost to non-small businesses. 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 this change to have a fiscal impact on entities outside of businesses or government because it only affects individuals who may qualify for services under the Medicaid program and providers of Medicaid services. While this filing may increase the number of individuals who become eligible for Medicaid services, there is no available data to estimate the number of individuals who will become eligible for Medicaid with the removal of the requirement to apply for other financial benefits, and that number is inestimable.

F. Compliance costs for affected persons:

There are no anticipated compliance costs for small businesses, non-small businesses, or other persons, including individuals who may qualify for Medicaid services, as this change is expected to only result in out-of-pocket savings for an individual who qualifies for Medicaid and an increase in revenue for a provider of Medicaid services. While the state is estimated to see a total cost of $262,747 based on an increase to the General Fund, its federal match, and an increase to the fund for Medicaid expansion in accordance with the Affordable Care Act. However, because there is no available data to estimate the number of individuals who will become eligible for Medicaid with the removal of the requirement to apply for other financial benefits, the amount of an individualized compliance cost is inestimable. UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 35 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 $262,747 $262,747 $262,747 $262,747 $262,747 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 $262,747 $262,747 $262,747 $262,747 $262,747 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 ($262,747) ($262,747) ($262,747) ($262,747) ($262,747) 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: 11/16/2026

12. Effective Date Information This rule change MAY become effective on: 11/23/2026 (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: 09/28/2026 designee and title: R414. Health and Human Services, Integrated Healthcare. R414-302. Eligibility Requirements. R414-302-8. Application for [Other Possible Benefits]Medicare Part B. [(1) The department implements 42 CFR 435.608, which requires applicants for and members of medical assistance to apply for and take reasonable steps to receive other possible benefits. (2) The department may not require an applicant for or member of medical assistance to apply for an income benefit if the applicant's ormember'sincomeisnotcounted when determining eligibility formedicalassistance foreitherthatindividual oranyotherhouseholdmember. 36 UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 NOTICES OF PROPOSED RULES (3)]([a]1) An individual who may be eligible for Medicare Part B benefits must apply for Medicare Part B and, if eligible, become enrolled in Medicare Part B to be eligible for Medicaid. ([b]2) The statepays the applicable monthly premium and cost-sharing expenses for Medicare Part B for an individual who is eligible for both Medicaid and Medicare Part B.[ (4) An individual whose eligibility is determined using non-ModifiedAdjusted Gross Income (MAGI) methodologies and who may be eligible for a VeteransAdministration (VA) apportionment payment of benefits, as defined by the VA, must apply for those benefits.] KEY: state residency, citizenship, third-party liability, Medicaid Date of Last Change: [January 22, 2024]2026 Notice of Continuation: January 6, 2023 Authorizing, and Implemented or Interpreted Law: [26B-3-108; ]26B-1-213; 26B-3-108 NOTICE OF SUBSTANTIVE CHANGE TYPE OF FILING: Repeal and Readopt Filing ID: 58275