Section 17b-262-504 - Services not coveredThe department shall not pay for the following inpatient psychiatric hospital services which are not covered under the Medical Assistance Program:
(a) procedures or services of an unproven, educational, social, research, experimental, or cosmetic nature or for any diagnostic, therapeutic, or treatment procedures in excess of those deemed medically necessary and appropriate by the department to treat the client's condition;(b) services that do not directly relate to the client's diagnosis, symptoms, or medical history;(c) services or items furnished for which the provider does not usually charge;(d) the day of discharge or transfer;(e) an inpatient psychiatric hospital admission or a day of care that does not meet all the department's requirements for inpatient services;(f) an inpatient psychiatric hospital admission or a day of care that is denied by the hospital's Utilization Review Committee;(g) a day when the client, who is age sixty-five or over, is absent from the psychiatric hospital at the midnight census, even though the leave or transfer is medically authorized and part of the treatment plan;(h) a day when the client, who is under age twenty-one, is absent from the psychiatric hospital at the midnight census, even though the leave or transfer is medically authorized and part of the treatment plan; or(i) costs associated with the education or vocational training of the client which shall be excluded from Medical Assistance Program payments.Conn. Agencies Regs. § 17b-262-504
Adopted effective March 6, 1998