004.07(C) OUT-OF-STATE MEDICAL.

If an out-of-state provider does not sign an agreement with the State Disability Medical program or Medicaid, and accept the reimbursement rate, the individual receiving State Disability Program medical is liable for his or her own medical bills. Payments may be approved for services provided outside Nebraska in the following situations: (i) When an emergency arises from accident or sudden illness while a recipient is visiting in another state and the recipient’s health would be endangered if care is postponed until the recipient returned to Nebraska or by traveling to Nebraska; (ii) When the recipient customarily obtains service in another state because the service is more accessible; (iii) When the recipient requires a medically necessary service that is not available in Nebraska but is available in another state; and (iv) When long term care services are provided in another state.