Page 24

Official source

Neonatal intensive care Unit (NICU) Services at Women’s and Infants Hospital. Except as specified in § 2.9(C) of this Part Special Education services as defined in the child’s Individual Education Plan (IEP) for children with special health needs or developmental delays Lead Program home assessment and non-medical case management provided by Department of Health or Lead Centers for lead poisoned children Cedar Family Center Services Centers of Excellence Programs 2.11 Limits on Services A. The following services are not covered under the RIte Care program: 1. Experimental procedures, except as required by Rhode Island State law; 2. Private rooms in hospitals (unless medically necessary); 3. Cosmetic surgery; 4. Medications that treat erectile dysfunction or other sexual disorders; 5. Infertility treatment services; and 6. Any portion of services that exceeds fifteen (15) days provided in an Institution for Mental Diseases (IMD) for individuals between the ages of twenty-one (21) to sixty-four (64). B. Out-of-State Coverage 1. Out-of-State Benefits — EOHHS does not routinely provide coverage for out-of-State services with certain exceptions: Medicaid services provided in border communities are covered and emergency services are covered, within limits, at the discretion of EOHHS or the MCO.

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Page 24

Official source

Neonatal intensive care Unit (NICU) Services at Women’s and Infants Hospital. Except as specified in § 2.9(C) of this Part Special Education services as defined in the child’s Individual Education Plan (IEP) for children with special health needs or developmental delays Lead Program home assessment and non-medical case management provided by Department of Health or Lead Centers for lead poisoned children Cedar Family Center Services Centers of Excellence Programs 2.11 Limits on Services A. The following services are not covered under the RIte Care program: 1. Experimental procedures, except as required by Rhode Island State law; 2. Private rooms in hospitals (unless medically necessary); 3. Cosmetic surgery; 4. Medications that treat erectile dysfunction or other sexual disorders; 5. Infertility treatment services; and 6. Any portion of services that exceeds fifteen (15) days provided in an Institution for Mental Diseases (IMD) for individuals between the ages of twenty-one (21) to sixty-four (64). B. Out-of-State Coverage 1. Out-of-State Benefits — EOHHS does not routinely provide coverage for out-of-State services with certain exceptions: Medicaid services provided in border communities are covered and emergency services are covered, within limits, at the discretion of EOHHS or the MCO.