SB 158

 Enrolled Copy  S.B. 158
1Recreational Therapy Program Amendments
                                       2026 GENERAL SESSION
                                            STATE OF UTAH
                                     Chief Sponsor: Todd Weiler
                                  House Sponsor: Karianne Lisonbee
2
3  LONG TITLE
4  General Description:
5      This bill amends provisions related to Medicaid reimbursement for recreational therapy.
6  Highlighted Provisions:
7      This bill:
8      ▸ adds to the list of recreational therapy facilities or programs that may be reimbursed for
9  recreational therapy under the Medicaid program a licensed residential support program
10  that is accredited by the American Camp Association;
11      ▸ authorizes the Department of Health and Human Services to apply for any necessary
12  waivers to implement the change; and
13      ▸ makes technical and conforming changes.
14  Money Appropriated in this Bill:
15      None
16  Other Special Clauses:
17      None
18  Utah Code Sections Affected:
19  AMENDS:
20      26B-3-227, as enacted by Laws of Utah 2023, Chapter 288
21
22  Be it enacted by the Legislature of the state of Utah:
23Section 1. Section 26B-3-227 is amended to read:
2426B-3-227 . Recreational therapy -- Reimbursement.
25  (1) As used in this section:
26      (a) "Assisted living facility" means the same as that term is defined in Section 26B-2-201.
27      (b) "Behavioral health program" means a behavioral health program described in [Title
2862A, Chapter 15, Substance Abuse and Mental Health Act] Title 26B, Chapter 5,
 S.B. 158  Enrolled Copy
29Health Care - Substance Use and Mental Health.
30(c) "General acute hospital" means the same as that term is defined in Section 26B-2-201.
31(d) "Intermediate care facility" means the same as that term is defined in Section
3258-15-101.
33(e) "Mental health therapist" means the same as that term is defined in Section 58-60-102.
34(f) "Qualified enrollee" means an individual who:
35(i) is enrolled in the Medicaid program; and
36(ii) has been referred for recreational therapy services by a mental health therapist.
37(g) "Recreational therapy services" means the same as that term is defined in Section
3858-40-102.
39(h) "Residential support program" means the same as that term is defined in Section
4026B-2-101.
41[(h)] (i) "Skilled nursing facility" means the same as that term is defined in Section
4258-15-101.
43[(i)] (j) "Youth residential treatment facility" means a facility that provides a 24-hour
44group living environment for four or more individuals who are under 18 years old
45and who are unrelated to the owner or provider of the facility.
46   (2) Before January 1, 2024, the department shall apply for a Medicaid waiver or a state plan
47with CMS to allow for reimbursement for recreational therapy services provided:
48(a) to a qualified enrollee;
49(b) by an individual authorized to engage in the practice of recreational therapy under
50Title 58, Chapter 40, Recreational Therapy Practice Act; and
51(c) at a:
52(i) general acute hospital;
53(ii) youth residential treatment facility;
54(iii) behavioral health program;
55(iv) intermediate care facility;
56(v) assisted living facility;
57(vi) skilled nursing facility;
58(vii) psychiatric hospital; [or]
59(viii) mental health agency[.] ; or
60(ix) licensed residential support program that is accredited by the American Camp
61Association.
62   (3) If the waiver or state plan amendment described in Subsection (2) is approved, the
                                                   -2-
 Enrolled Copy  S.B. 158
63      Medicaid program shall provide coverage to a qualified enrollee for recreational therapy
64      services.
65  (4) The department may seek approval from CMS for any waiver, amendment to an
66      existing waiver, or state plan amendment necessary to implement this section.
67Section 2. Effective Date.
68  This bill takes effect on May 6, 2026.
                                               -3-