601-1 - Resource - Cost Sharing Requirements

Effective Date:  March 1, 2017

Client contacts the Department of Health Administrative office:

(currently Justin Wadman, 801-538-6445 or email jwadman@utah.gov).

  1. If DWS receives the "Maximum Out of Pocket" form (MOOP), forward by mail or fax to:

Department of Health

Attn: Justin Wadman - BMHC

PO Box 143107

Salt Lake City, UT  84114-3107

or

Fax:  801-5386952

  1. If the form has already been imaged to the case record, send an email to:

jwadman@utah.gov and include "MOOP" in the subject line and in the body of the email, please provide the case name and case number.

  1. Maximum out of pocket amount owed will be verified and corrected to include premium late fee

o      Co-pays are not required for the remainder of the Certification Period if the maximum out of pocket amount is met.

o      MMIS system is updated to show "No Co-Pays" for applicable months in the certification period, the CHIP health plans are notified electronically.

o      The client will continue to use the same medical card for future months of eligibility remaining in the certification period.