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016.06.36-203.150. Physician's Role in Home Health Services.

AR ADC 016.06.36-203.150Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 36. Physician/Independent Lab/Crna/Radiation Therapy Center Provider Manual (Refs & Annos)
Section 203.000. Physician's Role in the Medicaid Program.
Ark. Admin. Code 016.06.36-203.150
016.06.36-203.150. Physician's Role in Home Health Services.
Currentness
A. Home health services are short-term and intermittent nursing care and physical therapy (when prescribed) in a client's home, under the direction of a physician.
B. Attending physicians may prescribe the following services when they are medically necessary for post-hospital care and periodic nursing care:
1. Home health aide
2. Skilled nursing
3. Physical therapy
4. Medical supplies
B. A physician's authorized and signed treatment plan must be on file with the home health agency before home health services may begin.
1. The prescribing physician must be the client's PCP unless the client is exempt from PCP program requirements.
a. The physician may add services to, or delete services from, the treatment plan submitted by the home health agency.
b. The physician may decline to prescribe home health, in accordance with his or her professional judgment.
c. Treatment plan authorization, revision and renewal must be by the physician's original signature only.
2. It is a federal requirement that the attending physician review an active treatment plan at intervals no greater than 60 days, for revision (if needed) or renewal.
3. The attending physician must maintain copies of home health treatment plans and all revisions to the treatment plans in clients' permanent files, in accordance with record-retention requirements in Section 202.000 of this manual.
B. Home health services are subject to an annual benefit limit per recipient. The annual benefit period is the State fiscal year (July 1 through June 30).
1. Extensions of benefits are considered for home health skilled nursing visits or home health aide visits for adults (21 years of age and older) at risk of institutionalization.
2. Benefit extensions are allowed for home health skilled nursing visits or home health aide visits for recipients under age 21 in the Child Health Services (EPSDT) Program if medically necessary.
3. The home health provider is responsible for requesting a benefit extension.
<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 016.06.36-203.150, AR ADC 016.06.36-203.150
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