Section 7.43.1000. Purpose.

Section 7.43.1002. Notification of option for home and community-based waiver services.

Section 7.43.1010. Recipient enrollment and eligibility.

Section 7.43.1020. Recipient disenrollment.

Section 7.43.1030. Screening, assessment, plan of care, and level of care determination.

Section 7.43.1035. Nursing oversight.

Section 7.43.1040. Requirements for all reimbursable waiver services.

Section 7.43.1041. Care coordination services.

Section 7.43.1042. Chore services.

Section 7.43.1043. Adult day services.

Section 7.43.1044. Residential supported living services.

Section 7.43.1045. Day habilitation services.

Section 7.43.1046. Residential habilitation services.

Section 7.43.1047. Supported employment services.

Section 7.43.1048. Intensive active treatment services.

Section 7.43.1049. Respite care services.

Section 7.43.1050. Amounts of reimbursement for home and community-based waiver services.

Section 7.43.1051. Specialized private duty nursing services.

Section 7.43.1052. Transportation services.

Section 7.43.1053. Meals services.

Section 7.43.1054. Environmental modification services.

Section 7.43.1055. Specialized medical equipment and supplies.

Section 7.43.1058. Amounts of reimbursement for home and community-based waiver services.

Section 7.43.1060. Determination of administrative and general cost rate.

Section 7.43.1070. Reimbursable leaves of absence.

Section 7.43.1080. Restrictions on residential supported living services reimbursement.

Section 7.43.1090. Provider certification and enrollment.

Section 7.43.1100. Provider disenrollment and decertification.

Section 7.43.1110. Definitions.

Section 7.43.1150. Purpose.

Section 7.43.1152. Recipient eligibility.

Section 7.43.1154. FASD diagnostic criteria.

Section 7.43.1156. Recipient enrollment and disenrollment for FASD/SED waiver services.

Section 7.43.1160. FASD/SED waiver services.

Section 7.43.1162. FASD/SED waiver plan of care standards.

Section 7.43.1164. Provider endorsement.

Section 7.43.1166. Plan of care development and coordination services.

Section 7.43.1168. Professional and paraprofessional training and consultation services.

Section 7.43.1170. Treatment and intervention mentor services.

Section 7.43.1172. FASD/SED day habilitation services.

Section 7.43.1174. FASD/SED residential habilitation services.

Section 7.43.1176. Community transition services.

Section 7.43.1178. Supported-employment development services; supported-employment ongoing services.

Section 7.43.1180. FASD/SED respite care services.

Section 7.43.1199. Definitions.

Section 7.43.1200. Scope.

Section 7.43.1210. Telemedicine applications; limitations.

Section 7.43.1220. Conditions for payment.

Section 7.43.1230. Exclusions.

Section 7.43.1240. Payment.

Section 7.43.1290. Definitions.

Section 7.43.1400. Program integrity.

Section 7.43.1440. Fiscal audit.

Section 7.43.1470. Use of statistical sampling.

Section 7.43.1490. Appeal.

Section 7.43.1800. Recovery of Medicaid expenditures.

Section 7.43.1810. Intentional program violations, program abuse, and criminal offenses.

Section 7.43.1850. Estate recovery.

Section 7.43.1885. Undue hardship.

Section 7.43.1890. Definitions.

Section 7.43.1900. Enrollment; general provisions; covered items and services.

Section 7.43.1905. Noncovered items and services.

Section 7.43.1910. Prior authorization.

Section 7.43.1920. Payment rates.

Section 7.43.1930. Purchase of items.

Section 7.43.1935. Replacement of items.

Section 7.43.1940. Rental of items; general provisions.

Section 7.43.1945. Rental of items; payment.

Section 7.43.1950. Rental of items; changes during rental periods.

Section 7.43.1955. Respiratory therapy equipment, supplies, and assessment visits.

Section 7.43.1960. Enteral and oral nutritional products.

Section 7.43.1970. Home infusion therapy.

Section 7.43.1980. Definitions.

Section 7.43.1990. Definitions.

Section 7.43.300. Eligibility, admission, and payment authorization(Repealed).

Section 7.43.302. ICF/MR interdisciplinary teams.(Repealed).

Section 7.43.305. Records, habilitative plan of care, treatment, and reevaluation(Repealed).

Section 7.43.310. Conditions for payment(Repealed).

Section 7.43.312. All-inclusive rate(Repealed).

Section 7.43.315. Absence from facility(Repealed).

Section 7.43.320. Transfer of recipients(Repealed).

Section 7.43.325. Discharge of recipients(Repealed).

Section 7.43.330. Applicability of prior sections(Repealed).

Section 7.43.333. Qualified mental retardation professionals(Repealed).

Section 7.43.335. Definitions(Repealed).

Section 7.43.350. Eligibility(Repealed).

Section 7.43.355. Treatment and services(Repealed).

Section 7.43.360. Payment(Repealed).

Section 7.43.365. Conditions for payment(Repealed).

Section 7.43.375. Standard hospital services(Repealed).

Section 7.43.380. Out-of-state hospitals(Repealed).

Section 7.43.385. Non-covered hospital services(Repealed).

Section 7.43.390. Retroactive coverage(Repealed).

Section 7.43.391. Retroactive coverage(Repealed).

Section 7.43.395. Length of hospitalization(Repealed).

Section 7.43.400. Billing(Repealed).

Section 7.43.405. Admission(Repealed).

Section 7.43.420. Outpatient and emergency room(Repealed).

Section 7.43.425. Drugs(Repealed).

Section 7.43.430. Utilization review(Repealed).

Section 7.43.435. Exclusions(Repealed).

Section 7.43.450. Purpose(Repealed).

Section 7.43.452. EPSDT program(Repealed).

Section 7.43.453. Podiatry services(Repealed).

Section 7.43.454. Nutrition services(Repealed).

Section 7.43.455. Provisions(Repealed).

Section 7.43.456. Private duty nursing services(Repealed).

Section 7.43.458. Hospice care for individuals under age 21(Repealed).

Section 7.43.460. Eligibility(Repealed).

Section 7.43.461. Payment for school-based services(Repealed).

Section 7.43.465. Periodicity of examination(Repealed).

Section 7.43.466. Targeted case management for children with disabilities(Repealed).

Section 7.43.467. Targeted case management payment rates(Repealed).

Section 7.43.470. Children's mental health services(Repealed).

Section 7.43.471. Severely emotionally disturbed children(Repealed).

Section 7.43.472. Family skill development services(Repealed).

Section 7.43.474. Group skill development services(Repealed).

Section 7.43.475. Separation of services(Repealed).

Section 7.43.476. Day treatment services(Repealed).

Section 7.43.478. Recipient support services(Repealed).

Section 7.43.479. Definitions related to children's mental health services(Repealed).

Section 7.43.480. Other provisions(Repealed).

Section 7.43.481. Behavioral rehabilitation services(Repealed).

Section 7.43.484. Prior authorization of mental health rehabilitation services(Repealed).

Section 7.43.486. Medical necessity determinations for mental health rehabilitation services(Repealed).

Section 7.43.488. Extension of service limitations in exceptional circumstances(Repealed).

Section 7.43.500. Prior authorization(Repealed).

Section 7.43.501. Transportation provider enrollment(Repealed).

Section 7.43.502. Transportation and accommodation services; general requirements(Repealed).

Section 7.43.503. Non-emergency transportation services(Repealed).

Section 7.43.505. Emergency transportation services(Repealed).

Section 7.43.507. Accommodation services(Repealed).

Section 7.43.509. Medical escort(Repealed).

Section 7.43.510. Type of transportation(Repealed).

Section 7.43.512. Prematernal home services(Repealed).

Section 7.43.515. Mortuary expenditure(Repealed).

Section 7.43.517. Payment for transportation and accommodations services(Repealed).

Section 7.43.519. Contracted transportation and accommodation services(Repealed).

Section 7.43.520. Public rates(Repealed).

Section 7.43.525. Medicare coverage(Repealed).

Section 7.43.530. Definitions(Repealed).

Section 7.43.550. Eligibility(Repealed).

Section 7.43.552. Admission(Repealed).

Section 7.43.555. Plan of care(Repealed).

Section 7.43.556. Services(Repealed).

Section 7.43.557. Per diem rate(Repealed).

Section 7.43.558. Appeals of the per diem rate(Repealed).

Section 7.43.560. Conditions for payment(Repealed).

Section 7.43.565. Patient funds(Repealed).

Section 7.43.570. Payment(Repealed).

Section 7.43.580. Definitions(Repealed).

Section 7.43.590. Drug coverage(Repealed).

Section 7.43.591. Drug reimbursement(Repealed).

Section 7.43.592. Medical supplies(Repealed).

Section 7.43.593. Drug use review(Repealed).

Section 7.43.594. Prior authorization and limitations on prescribed drugs.(Repealed).

Section 7.43.598. Medical supplies(Repealed).

Section 7.43.600. Payment for dental services(Repealed).

Section 7.43.605. Orthodontia(Repealed).

Section 7.43.610. Diagnostic X-ray(Repealed).

Section 7.43.615. Billings to patients(Repealed).

Section 7.43.620. Excluded dental services for recipients under 21 years of age(Repealed).

Section 7.43.625. Dental services for adults(Repealed).

Section 7.43.630. Vision care services(Repealed).

Section 7.43.633. Complete vision examination(Repealed).

Section 7.43.635. New frames(Repealed).

Section 7.43.636. Reimbursement for vision examinations(Repealed).

Section 7.43.640. Tempered lenses(Repealed).

Section 7.43.642. Reimbursement for vision services(Repealed).

Section 7.43.645. Exclusions(Repealed).

Section 7.43.647. Contracted frames and lenses(Repealed).

Section 7.43.650. Glasses(Repealed).

Section 7.43.655. Individual consideration(Repealed).

Section 7.43.656. Contracted frames and lenses(Deleted).

Section 7.43.670. Purpose(Repealed).

Section 7.43.672. Applicability(Repealed).

Section 7.43.673. Establishment of rates(Repealed).

Section 7.43.674. Objectives(Repealed).

Section 7.43.675. Medicaid Rate Advisory Commission operations and procedures(Repealed).

Section 7.43.676. Prospective rates defined.

Section 7.43.677. Methodology and criteria for proportionate share payments to hospitals under 42 U.S.C. 1396b(Repealed).

Section 7.43.678. Medicaid rate commission organization(Repealed).

Section 7.43.679. Establishment of uniform accounting, budgeting, and financial reporting(Repealed).

Section 7.43.680. Processing of annual year-end report(Repealed).

Section 7.43.681. Penalties(Repealed).

Section 7.43.682. Submission of budget amendments by health facilities(Repealed).

Section 7.43.683. Adjustment factors(Repealed).

Section 7.43.684. Processing of budgets and budget amendments(Repealed).

Section 7.43.685. Methodology and criteria for approval or modification of a payment rate(Repealed).

Section 7.43.686. Allowable reasonable operating costs(Repealed).

Section 7.43.687. Methodology and criteria for additional payments as a disproportionate share hospital(Repealed).

Section 7.43.688. Total financial requirements(Repealed).

Section 7.43.689. Optional payment rate methodology and criteria for small facilities(Repealed).

Section 7.43.690. Operating costs(Repealed).

Section 7.43.691. Year-end review(Repealed).

Section 7.43.692. Funded depreciation(Repealed).

Section 7.43.693. Facility audits and desk reviews(Repealed).

Section 7.43.694. Uniform system of budgeting and financial reporting(Repealed).

Section 7.43.695. OBRA '87-related continuing education for nurse aides(Repealed).

Section 7.43.696. Year-end reporting and conformance(Repealed).

Section 7.43.697. General procedures applicable to informal commission proceedings(Repealed).

Section 7.43.698. Cost allocation system(Repealed).

Section 7.43.699. Administrative appeal(Repealed).

Section 7.43.700. Health facility audits(Repealed).

Section 7.43.701. Procedure for establishment of rates(Repealed).

Section 7.43.702. Burden of proof(Repealed).

Section 7.43.703. Administrative appeal(Repealed).

Section 7.43.704. Appeal procedures(Repealed).

Section 7.43.708. Exceptional relief to prospective payment rate setting(Repealed).

Section 7.43.709. Definitions(Repealed).

Section 7.43.725. Conditions for payment(Repealed).

Section 7.43.726. Coverage for mental health clinic services(Repealed).

Section 7.43.727. Service limitations(Repealed).

Section 7.43.728. Clinical records, treatment plans, and assessments(Repealed).

Section 7.43.729. Rates.

Section 7.43.730. Definitions(Repealed).

Section 7.43.731. Client support services(Repealed).

Section 7.43.732. Psychosocial rehabilitation services(Repealed).

Section 7.43.733. Intensive rehabilitation services(Repealed).

Section 7.43.734. Mental health rehabilitation services(Repealed).

Section 7.43.735. Functional assessment(Repealed).

Section 7.43.736. Individual skill development services(Repealed).

Section 7.43.737. Case management(Repealed).

Section 7.43.738. Crisis intervention(Repealed).

Section 7.43.739. Medication administration services(Repealed).

Section 7.43.740. Substance abuse rehabilitative services(Repealed).

Section 7.43.741. Assessment and diagnosis services(Repealed).

Section 7.43.742. Outpatient services(Repealed).

Section 7.43.743. Intensive outpatient services(Repealed).

Section 7.43.744. Intermediate services(Repealed).

Section 7.43.745. Medical services(Repealed).

Section 7.43.746. Limitations and payments for services(Repealed).

Section 7.43.750. Purpose and scope of personal care services(Repealed).

Section 7.43.751. Personal care assessment tool (PCAT).

Section 7.43.752. Covered services(Repealed).

Section 7.43.755. Excluded services(Repealed).

Section 7.43.760. Place of service(Repealed).

Section 7.43.765. Agency-based program; service plan(Repealed).

Section 7.43.766. Consumer-directed program; service plan(Repealed).

Section 7.43.768. Consumer-directed program; recipient requirements(Repealed).

Section 7.43.770. Employment of personal care assistants; qualifications(Repealed).

Section 7.43.771. Agency-based program; personal care assistant education and training requirements(Repealed).

Section 7.43.772. Independent personal care attendants(Repealed).

Section 7.43.775. Responsibilities of personal care assistant(Repealed).

Section 7.43.780. Agency-based program; supervising registered nurse(Repealed).

Section 7.43.785. Responsibilities of the recipient's physician(Repealed).

Section 7.43.786. Consumer-directed program; personal care agencies(Repealed).

Section 7.43.787. Agency-based program; personal care agencies(Repealed).

Section 7.43.788. Safety of recipients(Repealed).

Section 7.43.789. Consumer-directed and agency-based programs; safety of employees; termination of service(Repealed).

Section 7.43.790. Payment for services(Repealed).

Section 7.43.791. Review and appeal rights(Repealed).

Section 7.43.792. Consumer-directed and agency-based programs; compliance reviews(Repealed).

Section 7.43.793. Provider certification and enrollment(Repealed).

Section 7.43.794. Provider decertification and disenrollment(Repealed).

Section 7.43.795. Definitions(Repealed).

Section 7.43.800. Home health care services and coverage(Repealed).

Section 7.43.801. Requirements for home health care services(Repealed).

Section 7.43.805. Payment for care(Repealed).

Section 7.43.810. Billing rate(Repealed).

Section 7.43.815. Use of alternative resources(Repealed).

Section 7.43.820. Definitions(Repealed).

Section 7.43.825. Program(Repealed).

Section 7.43.830. Payment for services(Repealed).

Section 7.43.835. Definition(Repealed).

Section 7.43.850. Enrollment and reporting(Repealed).

Section 7.43.855. Covered services(Repealed).

Section 7.43.860. Payment(Repealed).

Section 7.43.865. Medicare coverage(Repealed).

Section 7.43.866. Re-basing(Repealed).

Section 7.43.868. Exceptional relief(Repealed).

Section 7.43.870. Enrollment and reporting(Repealed).

Section 7.43.871. Exceptional relief(Repealed).

Section 7.43.872. Payment for services(Repealed).

Section 7.43.873. Re-basing(Repealed).

Section 7.43.874. Definitions(Repealed).

Section 7.43.875. Covered services(Repealed).

Section 7.43.880. Conditions for payment(Repealed).

Section 7.43.885. Payment(Repealed).

Section 7.43.890. Billing rate(Repealed).

Section 7.43.895. Reports(Repealed).

Section 7.43.910. Conditions of and limitations on payment(Repealed).

Section 7.43.920. Covered services(Repealed).

Section 7.43.921. Physical therapy(Repealed).

Section 7.43.922. Advanced nurse practitioner services(Repealed).

Section 7.43.923. Occupational therapy services(Repealed).

Section 7.43.924. Nutrition services for pregnant women(Repealed).

Section 7.43.925. Durable medical equipment, supplies, and respiratory therapy(Repealed).

Section 7.43.926. Speech-language pathology services(Repealed).

Section 7.43.927. Hearing services and items(Repealed).

Section 7.43.928. Substance abuse rehabilitative services(Expired).

Section 7.43.929. Assessment and diagnosis services(Expired).

Section 7.43.930. Outpatient services(Expired).

Section 7.43.931. Intensive outpatient services(Expired).

Section 7.43.932. Counseling services(Expired).

Section 7.43.933. Care coordination(Expired).

Section 7.43.934. Intermediate services(Expired).

Section 7.43.935. Psycho-social development services(Expired).

Section 7.43.936. Medical services(Expired).

Section 7.43.937. Detoxification services(Expired).

Section 7.43.938. Hospice care(Repealed).

Section 7.43.939. Payment for hospice care services(Repealed).

Section 7.43.940. X-ray services(Repealed).

Section 7.43.941. Registered nurse anesthetists(Repealed).

Section 7.43.942. Direct-entry midwife services(Repealed).

Section 7.43.944. Payment for free-standing birth center services(Repealed).

Section 7.43.946. Psychologist services(Repealed).

Section 7.43.948. Payment for psychologist services(Repealed).

Section 7.43.950. Grounds for sanctioning providers(Repealed).

Section 7.43.955. Sanctions.

Section 7.43.960. Imposition of sanction(Repealed).

Section 7.43.965. Scope of sanction.

Section 7.43.970. Notice of sanction(Repealed).

Section 7.43.975. Provider education(Repealed).

Section 7.43.977. Quality assurance(Repealed).

Section 7.43.980. Appeal of sanction(Repealed).

Section 7.43.982. Restrictions on payments(Repealed).

Section 7.43.983. Withholding of payments(Repealed).

Section 7.43.985. Definitions(Repealed).

Section 7.43.990. Definitions(Relocated).