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016.06.58-214.000. Exclusions.

AR ADC 016.06.58-214.000Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 58. Children's Services Targeted Case Management Provider Manual (Refs & Annos)
Section 210.000. Program Coverage.
Ark. Admin. Code 016.06.58-214.000
016.06.58-214.000. Exclusions.
Currentness
Services not appropriate for Children's Services targeted case management and not covered under the Arkansas Medicaid Program include, but are not limited to:
A. Targeted case management for recipients who are receiving case management services through the DDS Alternative Community Services Waiver Program.
B. The actual provision of services or treatment. Examples include, but are not limited to:
1. Training in daily living skills.
2. Training in work skills, social skills and/or exercise.
3. Training in housekeeping, laundry and cooking.
4. Transportation services.
5. Counseling or crisis intervention services.
C. Services that go beyond assisting individuals in gaining access to needed services. Examples include, but are not limited to:
1. Supervisory activities.
2. Paying bills and/or balancing the recipient's checkbook.
3. Observing a recipient receiving a service, e.g., physical therapy, speech therapy and classroom instruction.
4. Travel and/or waiting time.
D. Case management services that duplicate services provided by public agencies or private entities under another program authorized for the same purpose. For example, targeted case management services provided to foster children duplicate payments made to a public agency and are therefore not reimbursable.
E. Case management services that duplicate integral and inseparable parts of other Medicaid or Medicare services (for example, home health services) when provided on the same date of service.
F. Case management services provided to inpatients. Discharge planning is a required service of inpatient facilities. These facilities include, but are not limited to acute care hospitals, rehabilitative hospitals, inpatient psychiatric facilities, nursing homes and residential treatment facilities.
G. Case management services provided while transporting a recipient.
H. Time spent billing for targeted case management services.
I. Time spent determining medical and financial eligibility for Children's Services.
J. Any activity related to Children's Services authorization and payment of services.

Credits

Eff. Jan. 1, 2005.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.58-214.000, AR ADC 016.06.58-214.000
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