23 Miss. Code. R. 215-1.1

Current through December 10, 2024
Rule 23-215-1.1 - Definitions

The Division of Medicaid defines:

A. Home health services as skilled nursing visits, home health aide visits, and durable medical equipment, supplies and appliances provided to a beneficiary:
1. At the beneficiary's place of residence,
2. Ordered by the beneficiary's physician or non-physician practitioner (NPP) as part of a written plan of care reviewed by the physician or NPP every sixty (60) days.
B. Residence as any setting in which normal life activities take place, other than a hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, or any setting in which payment is or could be made under Medicaid for inpatient services that include room and board.
C. Durable medical equipment, supplies and appliances in Miss. Admin Code Title 23, Part 209.
D. Out-patient setting as any setting where a beneficiary receives services and is not admitted as a resident or inpatient.
E. Order as the certification of need for home health services.
F. Recertification as the certification of continued need for home health services.
G. A face-to-face encounter, for home health services, as an in person visit, including telehealth, which occurs between a physician or allowed non-physician practitioner and a beneficiary for the primary reason the beneficiary requires home health services and must occur no more than ninety (90) days before or thirty (30) days after the start of home health services.
H. Allowed non-physician practitioner (NPP) as a:
1. Nurse practitioner or clinical nurse specialist working in collaboration with the beneficiary's physician, or
2. Physician assistant under the supervision of the beneficiary's physician.

23 Miss. Code. R. 215-1.1

42 C.F.R. § 440.70; Miss. Code Ann. §§ 43-13-117, 43-13-121.
Amended 9/1/2018
Amended 7/1/2021