Ala. Admin. Code r. 560-X-12-.09

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-12-.09 - Visits

(1) A visit is a personal contact in the place of residence of a patient made for the purpose of providing a covered service by a health worker on the staff of a certified Medicaid home health agency.

(a) Home health care visits to Medicaid recipients must be medically necessary and in accordance with a Medicaid Home Health Certification form established by a licensed physician or non-physician practitioners (NPP). Home Health records are subject to onsite audits and desk reviews by the professional staff of the Alabama Medicaid Agency.

(b) Home health care visits are limited to one hundred four (104) per calendar year.

(2) If a Medicaid recipient receiving home health visits is institutionalized and is referred to home health upon discharge from the institution, a new Medicaid Home Health Certification form must be completed and retained by the home health agency.

Ala. Admin. Code r. 560-X-12-.09

Rule effective October 1, 1982. Amended effective July 8, 1983; January 8, 1986; January 13, 1988; February 9, 1989.

Amended by Alabama Administrative Monthly Volume XXXIX, Issue No. 01, October 30, 2020, eff. 12/14/2020.

Authors: Ruth Chambliss, Christine Luna, Theresa D. Richburg

Statutory Authority: Title XIX, Social Security Act; 42 C.F.R. § 441.15; State Plan.