Primary Children's Hospital v. Utah Department of Health, Division of Health Care Financing

OPINION

DAVIS, Judge:

¶ 1 Primary Children’s Hospital (Primary) petitions this court for review of a final agency decision denying -Medicaid reimbursement for failure to obtain prior authorization for services. We reverse.

FACTS

¶ 2 In March of 1997, five-year-old Sean Daugaard was admitted to Primary and later diagnosed with Acute Lymphoblastic Leukemia. Chemotherapy was unsuccessful, and Sean’s physician concluded that a bone marrow transplant was necessary to save Sean’s life. Because the family did not have the means to pay for the transplant, Richard Fairborn, Primary’s resource counselor,…