Regulation .04 Covered Services.
Regulation .04 Covered Services.LinkCopy Citation
Providers may be capitated for one of the following packages of services subject to the approval of the Department:
A.
Inpatient hospital services, as long as the applicant, if regulated by the Health Services Cost Review Commission, has received permission from that agency to receive capitation payments;
B.
Mental health services, including but not limited to, psychiatric inpatient treatment and community mental health outpatient services;
C.
Not more than two of the following services or groups of services:
(1)
Outpatient hospital services,
(2)
Physician services,
(3)
Laboratory and X-ray services,
(4)
Nursing facility services, EPSDT, and family planning services, and
(5)
Home health services;
D.
Any service covered by the Program other than a service specified in §A or C of this regulation;
E.
Inpatient hospital services as listed in §A of this regulation, plus one or more of the services included in §D of this regulation; or
F.
Not more than two of the services listed in §C of this regulation, plus one or more of the services included in §D of this regulation.