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STATE CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT

STATE: Virginia Page 6-45

Effective Date: 07/01/05

45 Approval Date: _____________/06 prosthetic-orthotic services, psychology, social work, and therapeutic recreation.

B. Optometrist: Diagnostic examination and optometric treatment procedures and services by ophthalmologists, optometrists, and opticians, as allowed by the Code of VA and by regulations of the Boards of Medicine and of Optometry, are covered. Routine refractions are limited to once in 24 months except as may be authorized by DMAS. C. Podiatrists: Covered podiatry services are defined as reasonable and necessary diagnostic, medical, or surgical treatment of disease, injury, or defects of the human foot. These services must be within the scope of the license of the podiatrists’ profession and defined by State law. The following services are not covered: preventive health care, including routine foot care: treatment of structural misalignment not requiring surgery; cutting or removal of corns, warts, or calluses; experimental procedures; acupuncture. D. Nursing facility services in a Medicaid certified facility (other than in an IMD). E. Nurse-midwife services- defined as those services allowed under the licensure requirements of the state statute and as specified in the Social Security Act. F. Disease Management Program with benefits that are essentially the same as the state’s Title XIX Plan.

6.2.25.A ⌧ Premiums for private health care insurance coverage (Section 2110(a)(25))

6.2.26.A ⌧ Medical transportation (Section 2110(a)(26)) Transportation services are provided to ensure that recipients have necessary access to and from providers of all covered medical services. Transportation to both emergency and nonemergency services are covered. 6.2.27.A Enabling services (such as transportation, translation, and outreach services (See instructions) (Section 2110(a)(27))

6.2.28.A ⌧ Any other health care services or items specified by the Secretary and not included under this section (Section 2110(a)(28))