Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.17-027 - Emergency: Eligibility

Current through Register Vol. 49, No. 6, June, 2024
Summary of Changes
The Medicaid State Plan has been revised for determining
				eligibility for certain existing categories and new group of eligibles using
				the Medicaid Modified Adjusted Gross Income (MAGI) methodology effective
				January 1, 2014. Also establishes the new mandatory groups in accordance with
				Federal law.
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What happens next?
We will process your
				application for Medicaid, ARKids First or the Health Care Independence Program
				and send you a notice to tell you if your application for coverage has been
				approved or denied and provide Instructions on the next steps needed to
				complete your health coverage application. If you are not eligible for any of
				these programs, we will screen your application for potential eligibility for
				tax credits to help pay for health insurance premiums and then transfer your
				information to the Health Insurance Marketplace. We will provide instructions
				on how to complete the application process on the notice we send to you.
APPENDIX A for
				DCO-151/152
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APPENDIX B for DCO-151/152
'American Indian or/Alasfca Native family Member,
				(AI/AN),
Complete this appendix if you or a family member are an
				American Indian or Alaska Native, Submit this with your Application for Health
				Coverage.
Tell us about your American Indian or Alaska Native
				family member(s).
American Indians and Alaska Natives can get services from the
				Indian Health Services, tribal health programs or urban Indian health programs.
				They also may not have to pay cost sharing and may get special monthly
				enrollment periods. Answer the following questions to make sure your family
				gets the most help possible.
NOTE:
If you have more people to include, make a
				copy of this page and attach.
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Attachment 2.6-A
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STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
ELIGIBILITY CONDITIONS AND REQUIREMENTS
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21.
RESERVED
22. Respiratory care services (in accordance
			 with Section 1902(e)(9)(A) through (C) of the Act).
Respiratory care for ventilator-dependent individuals
				means services that are not otherwise available under the State's Medicaid
				plan, provided on a part-time basis in the recipient's home by a respiratory
				therapist or other health care professional trained in respiratory therapy to
				an individual who?
a.
Is
			 medically dependent on a ventilator for life support at least 6 hours per
			 day;
b.
Has been so
			 dependent for at least a number of consecutive days (number is based on maximum
			 number of days authorized under the State plan, whichever is less) as an
			 inpatient in one or more hospitals, NFs, orlCFs/MR;
c.
Except for the availability of
			 respiratory care services, would require respiratory care as an inpatient in a
			 hospital, NF, or ICF/MR and would be eligible to have payment made for
			 inpatient care under the State plan;
d.
Has adequate social support
			 services to be cared for at home;
e.
Wishes to be cared for at home;
			 and
f.
Receives
			 services under the direction of a physician who is familiar with the technical
			 and medical components of home ventilator support, and who has medically
			 determined that in-home care is safe and feasible for the individual.
1. Ventilator Equipment (i.e., ventilator,
			 suction pump, oxygen concentrator, liquid oxygen, liquid oxygen walker and
			 reservoir, ventilator supplies and hospital bed) including 24-hour availability
			 of respiratory therapy and equipment maintenance, with prior
			 authorization.
2.
Respiratory
			 therapy/treatment services for ventilator-dependent recipients under age 21,
			 with prior authorization.
1.
			 Ventilator Equipment (i.e., ventilator, suction pump, oxygen concentrator,
			 liquid oxygen, liquid oxygen walker and reservoir, ventilator supplies and
			 hospital bed) including 24-hour availability of respiratory therapy and
			 equipment maintenance, with prior authorization.
2.
Respiratory therapy/treatment
			 services for ventilator-dependent recipients under age 21, with prior
			 authorization.
METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATESOTHER TYPES
				OF CARE
RESERVED