Regulation .05 Benefits — Home Health Services.
Regulation .05 Benefits — Home Health Services.LinkCopy Citation
A.
Subject to the conditions specified in §B of this regulation, an MCO shall provide to its enrollees medically necessary home health services, including:
(1)
Skilled nursing services, including the supervisory visits required by §A(2) of this regulation;
(2)
Home health aide services, including biweekly supervisory visits by a registered nurse in the recipient's home, every second visit of which includes observations of the delivery of services by the aide to the enrollee;
(3)
Physical therapy services;
(4)
Occupational therapy services;
(5)
Speech pathology services; and
(6)
Medical supplies that are used during a home health visit.
B.
An MCO shall provide the home health services specified in §A of this regulation that are:
(1)
Certified by the enrollee's PCP or by the enrollee's attending physician to be required on a part-time, intermittent basis; and
(2)
Rendered in the enrollee's home.