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North Carolina Department of Health and Human Services AGED, BLIND, AND DISABLED MEDICAID MANUAL

MA-200

DEFINITIONS

19 REISSUED 03/01/11 – CHANGE NO. 03-11 (III.) Incur --- Become liable for, regardless of whether the expense is paid or expected to be paid by insurance, including Medicare, or some other source.

Incurred Medical Expense --- A charge for a medical service provided to an individual regardless of whether it is paid or unpaid. It may be applied to the Medicaid deductible if it will not be reimbursed.

In-Home Health Services and Supplies---Medically necessary services provided to an applicant/recipient (a/r) by a Medicaid certified provider can be sanctioned due to a transfer of assets. These services include the following:

a. Durable Medical Equipment (DME) and related medical supplies such as wheelchairs, walkers, canes, hospital beds, oxygen and oxygen equipment, needed to maintain or improve a recipient’s medical, physical, or functional level.

b. Home Health Services covers home health aide services, skilled nursing, physical therapy, speech pathology and audiology, and occupational therapy provided by a Medicaid certified home health agency to help restore, rehabilitate or maintain a recipient in the home.

c. Home Health Supplies include items such as adult diapers, disposable bed pads, catheter and ostomy supplies provided by a Home Health or Private Duty Nursing (PDN) agency. PDN services are not provided to individuals in an Adult Care Home (ACH).

d. Home Infusion Therapy (HIT) covers self-administered therapies such as nutrition therapy (tube feeding), drug therapy including chemotherapy for cancer treatments, antibiotic therapy and pain management therapy.

e. Personal Care Services (PCS) are personal care activities such as bathing, toileting, monitoring vital signs, housekeeping and home management tasks essential for maintaining the recipient’s health performed by an in-home aide in a private residence.

PCS services provided to individuals in an ACH are not subject to this policy. Refer to MA-2240, Transfer of Assets, for an explanation of services.

In-kind Income --- Non-monetary assistance such as food, shelter or something the individual can use or convert to obtain food, or shelter.

Inmate of a Public Institution --- A person who is living in a public institution.

Inquiry --- A request for information regarding assistance or other services.

Institutional Living Arrangement – Institution or establishment that provides food, shelter and some treatment to 4 or more persons who are not related to the owner. This includes nursing facilities, group homes, orphanages, adult care homes, and residential treatment facilities.