Ala. Admin. Code r. 560-X-17-.07

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

Section 560-X-17-.07 - Special Situations

(1) Eye Care for Patients Eligible for Both Medicare and Medicaid. See the Medicaid Provider Manual for instructions in filing claims when the Medicaid patient is entitled to benefits covered by Medicare.

(2) If eyeglasses are prescribed under conditions not covered by Medicare, instructions and procedures appearing in other paragraphs of this chapter should be followed.

(3) Unusual Situations.

(a) Services for unusual situations may be provided when prior authorized. Full, written information justifying medical necessity must be sent to Medicaid prior to the service being rendered.

(b) Please refer to Rule 560-X-17-.01(3) for prior authorization procedures.

Ala. Admin. Code r. 560-X-17-.07

Rule effective October 1, 1982. Amended: effective January 13, 1988. Amended: Filed January 17, 2012; effective February 21, 2012.

Author: Jacquelyn King, Program Manager; Medical Support

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §401 et. seq.