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UNOFFICIAL 1737-62

(f) The statewide reimbursement rate shall be the rate negotiated by the department. The final rate will be based on the following factors: (1) Cost to provide the service; (2) Comparison to comparable Medicaid provider types; (3) Relative value to other services within the established fee schedule; (4) Rate will not exceed Medicare’s upper limit of reimbursement; and (5) Rate will be reevaluated at a minimum of once every two years for its cost basis and allowability. (g) Reimbursement shall be based of the following units of service: (1) Per contact (Crisis management services); (2) Daily (crisis residential, therapeutic support, intensive outpatient hospital services), or (2) Fifteen minute increments (assertive community treatment (ACT), biopsychosocial rehabilitative programs and intensive family intervention). [Eff 02/07/05] (Auth: HRS §346-14) (Imp: 42 C.F.R. §440.130)

§17-1737-45 Home health services. (a) Home health services means services provided to a recipient by a home health agency or under a home or community-based waiver: (1) At the recipient's place of residence or at a location other than a hospital, skilled nursing facility, intermediate care

facility - mental retardation, or intermediate care facility; (2) On a physician's orders as part of a written plan of care that the physician reviews every sixty days; and (3) Medical authorization as specified in section 17-1739-4 is needed for all home health services, medical supplies, equipment and appliances unless otherwise specified under this section.

(b) Home health services shall include: (1) Nursing service, as defined in chapter 457, HRS provided on a part-time or intermittent basis; (2) Home health aide services;