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More services for indigent residents around corner
Additional services for indigent residents will soon be available after action taken by the Aransas County commissioners court at a regular term meeting Monday, Sept. 14.
The court unanimously approved Resolution No. R-09-17 authorizing the adoption of certain optional health care services which are credited expenses toward Aransas County’s eight percent GRTL wherein cost sharing begins with the State of Texas.
The resolution states “whereas the Commissioners’ court of Aransas County desires to develop a more adaptable and efficient baseline health care program for indigent residents of this County and provide for the common good health of this community” and ‘whereas Aransas County recognizes that the general good health and resultant cost containment of medical care is of importance to the economic well-being of all residents of the County.
“Now, therefore, be it resolved by the commissioners’ court of Aransas County that the following optional services be adopted as expanded services of aransas county indigent health care:
“1. Ambulatory Surgical Center (ASC) - Services must be provided in a Title XIX Medicaid-enrolled ASC, and are limited to items and services furnished in reference to an ambulatory surgical procedure, including those services on the HCFA approved list and selected Medicaid-only procedure.
“2. Physician Assistance (PA) - These services must be *Medically Necessary, *Under the direction of a M.D. or D.O., *Must be billed and paid to the supervising physician.
“3. Advanced Practice Nurse (APN) - These services must be *Medically Necessary, *Provided within the scope of practice of the APN, *Covered in the Texas Medicaid program when provided by a licensed physician.
“4. Certified Registered Nurse Anesthetist (CRNA) - These services must be *Medically Necessary, *Provided within the scope of practice of a CRNA, *Prescribed and supervised by *a physician, dentist or podiatrist who must be licensed in the State of Texas, *Provided under the direction of supervising physician.
“5. Diabetic Supplies and/or Equipment - These supplies and equipment must be *Medically Necessary and prescribed by a physician. Prior authorization by the County by Purchase Voucher will be required. Items covered are (a) Lancets, (b) Alcohol pre pads, © Test strips, (d) Syringes. These will be limited per patient per month to a thirty-day supply.
“6. Colostomy Medical Supplies & Equipment - These supplies and equipment must be medically necessary and prescribed by a physician. Prior authorization by Purchase Voucher will be required. Items covered are (a) Colostomy bags/pouches, (b) cleansing irrigation kits, © paste or powder, (d) wafers.
“7. Home and Community Health Care Services - These services must be medically necessary; meet the Medicare/Medicaid requirements; and be provided by a certified home health agency. A plan of care must be recommended, signed, and dated by the recipient’s attending physician prior to care being given. The County will require prior authorization for items covered which are (a) RN visits for skilled nursing observation, assessment, evaluation, and treatment, provided a physician specifically requests the R.N. visit for this purpose. A county Purchase Voucher will be required.
“8. Home oxygen equipment and oxygen, including masks, oxygen hose, and nebulizers with prior authorization by Purchase Voucher on a case-by-case basis.
“9. Purchase insurance coverage towards state assistance by submitting a written request to the Department of Health demonstrating the cost effectiveness and receiving prior approval from the Department of Health. This would be done on a case-by-case basis, i.e. when applicant has option for continuing current medical insurance such as COBRA but lacks funds to pay premiums.
“10. Counseling Services - These services must be medically necessary, meet the Medicare/Medicaid requirements. Services to be provided by (a.) Licensed Professional Counselor (LPC), or (b.) Licensed Marriage Family Therapist (LMFT), or (c.) Licensed Professional Counselor (LPC), or (d.) PhD. Clinical Psychologist.
“11. Dental Care These services must be medically necessary and provided by a DD, a DMD, or DDM. The County will require prior authorization by Purchase Voucher. Items covered are: emergency dental care, consisting of extraction, or filling of a tooth due to abscess, infection or extreme pain.
“12. Vision Care - County will require prior authorization by Purchase Voucher. Items covered will be one examination of the eyes by refraction every 24 months. Medicaid guidelines will be followed. No eyeglasses will be provided.
“13. Other - Medically necessary services or supplies that the local governmental municipality/entity determines to be cost effective.”
The court unanimously approved Resolution No. R-09-17 authorizing the adoption of certain optional health care services which are credited expenses toward Aransas County’s eight percent GRTL wherein cost sharing begins with the State of Texas.
The resolution states “whereas the Commissioners’ court of Aransas County desires to develop a more adaptable and efficient baseline health care program for indigent residents of this County and provide for the common good health of this community” and ‘whereas Aransas County recognizes that the general good health and resultant cost containment of medical care is of importance to the economic well-being of all residents of the County.
“Now, therefore, be it resolved by the commissioners’ court of Aransas County that the following optional services be adopted as expanded services of aransas county indigent health care:
“1. Ambulatory Surgical Center (ASC) - Services must be provided in a Title XIX Medicaid-enrolled ASC, and are limited to items and services furnished in reference to an ambulatory surgical procedure, including those services on the HCFA approved list and selected Medicaid-only procedure.
“2. Physician Assistance (PA) - These services must be *Medically Necessary, *Under the direction of a M.D. or D.O., *Must be billed and paid to the supervising physician.
“3. Advanced Practice Nurse (APN) - These services must be *Medically Necessary, *Provided within the scope of practice of the APN, *Covered in the Texas Medicaid program when provided by a licensed physician.
“4. Certified Registered Nurse Anesthetist (CRNA) - These services must be *Medically Necessary, *Provided within the scope of practice of a CRNA, *Prescribed and supervised by *a physician, dentist or podiatrist who must be licensed in the State of Texas, *Provided under the direction of supervising physician.
“5. Diabetic Supplies and/or Equipment - These supplies and equipment must be *Medically Necessary and prescribed by a physician. Prior authorization by the County by Purchase Voucher will be required. Items covered are (a) Lancets, (b) Alcohol pre pads, © Test strips, (d) Syringes. These will be limited per patient per month to a thirty-day supply.
“6. Colostomy Medical Supplies & Equipment - These supplies and equipment must be medically necessary and prescribed by a physician. Prior authorization by Purchase Voucher will be required. Items covered are (a) Colostomy bags/pouches, (b) cleansing irrigation kits, © paste or powder, (d) wafers.
“7. Home and Community Health Care Services - These services must be medically necessary; meet the Medicare/Medicaid requirements; and be provided by a certified home health agency. A plan of care must be recommended, signed, and dated by the recipient’s attending physician prior to care being given. The County will require prior authorization for items covered which are (a) RN visits for skilled nursing observation, assessment, evaluation, and treatment, provided a physician specifically requests the R.N. visit for this purpose. A county Purchase Voucher will be required.
“8. Home oxygen equipment and oxygen, including masks, oxygen hose, and nebulizers with prior authorization by Purchase Voucher on a case-by-case basis.
“9. Purchase insurance coverage towards state assistance by submitting a written request to the Department of Health demonstrating the cost effectiveness and receiving prior approval from the Department of Health. This would be done on a case-by-case basis, i.e. when applicant has option for continuing current medical insurance such as COBRA but lacks funds to pay premiums.
“10. Counseling Services - These services must be medically necessary, meet the Medicare/Medicaid requirements. Services to be provided by (a.) Licensed Professional Counselor (LPC), or (b.) Licensed Marriage Family Therapist (LMFT), or (c.) Licensed Professional Counselor (LPC), or (d.) PhD. Clinical Psychologist.
“11. Dental Care These services must be medically necessary and provided by a DD, a DMD, or DDM. The County will require prior authorization by Purchase Voucher. Items covered are: emergency dental care, consisting of extraction, or filling of a tooth due to abscess, infection or extreme pain.
“12. Vision Care - County will require prior authorization by Purchase Voucher. Items covered will be one examination of the eyes by refraction every 24 months. Medicaid guidelines will be followed. No eyeglasses will be provided.
“13. Other - Medically necessary services or supplies that the local governmental municipality/entity determines to be cost effective.”
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