Current through September, 2024
Section 17-1737-3 - Inpatient hospital care(a) Inpatient hospital care means services that are ordinarily furnished in a hospital for the care and treatment of inpatients under the direction of a physician, podiatrist, or dentist and which is furnished by an institution meeting the following requirements: (1) Is not maintained primarily for the treatment of tuberculosis, mental diseases, or Hansen's disease;(2) Is licensed as a hospital by the State;(3) Meets the requirements for medicare participation; and(4) Has in effect a utilization review plan approved by the department.(b) Inpatient hospital care shall include the following:(1) Ward or semiprivate accommodations including bed and meals, or a private room when medically indicated;(3) Drugs, dressings, and diagnostic and therapeutic procedures as prescribed by the attending physician; and(4) Other ancillary services associated with hospital care except private duty nursing.(c) The department shall not pay for inpatient hospital care in the following instances: (1) Patients whose medical needs do not require admission for acute inpatient care;(2) Diagnostic procedure which may be performed on an outpatient basis;(3) Personal comfort items furnished by the hospital; and (4) Partial hospitalization, day, evening, or night care, except for a patient receiving a surgical procedure or test which would permit return to the patient's home on the same day.[Eff 08/01/94] (Auth: HRS § 346-14) (Imp: 42 C.F.R. §440.10 )