Current through Register Vol. 54, No. 49, December 7, 2024
Section 175.84 - Procedures(a)Services paid for. The Department will pay for the following medical services for eligible persons who are taking care of their everyday living expenses themselves, but have insufficient income, according to law and regulations, to pay for these major medical expenses: (1)Inpatient hospital care. The same as for categorically needy medical assistance recipient as set forth in § 175.73 (relating to requirements).(2)Hospital-home care. The same as for categorically needy medical assistance recipient as set forth in § 175.73.(3)Nursing care in the home. The same as for categorically needy medical assistance recipient as set forth in § 175.73.(4)Skilled nursing and intermediate care in public and private facilities. Payments may continue for as long as the need and eligibility continue and may be made for persons who meet any of the following criteria:(i) 65 years of age or over.(ii) 21 years of age or over and who are blind.(iii) Under the age of 21.(iv) Parents of a dependent child.(v) 21 years or over and who are permanently and totally disabled.(vi) 16 years of age or under needing skilled nursing home care in state schools and hospitals.(5)Care in a mental institution. The same as for categorically needy individual assistance recipient as set forth in § 175.73.(6)Medical-social services. Specific social services related to illness will be provided as needed to persons applying for or receiving medical assistance. This will include social services in medical emergencies.(7)Transportation. Ambulance services and related transportation needs.(b)Identification cards. A paper Medical Assistance Identification Card, PA 5-C for medically needy recipients, will be issued to certify the eligibility of a person for medical assistance. In addition, an embossed plastic card may be issued as a convenience for pharmacists in preparing invoices. The paper ID card will be the only card entitling an individual to medical assistance. A plastic card has no value without the appropriate Medical Assistance Identification Card.(c)Quarterly reports. Quarterly reports will be prepared in accordance with the following:(1) The CAO will prepare quarterly calendar reports by memorandum of the total number of PA-5C ID cards by category issued in the quarter. A negative report will be submitted if no cards were issued in particular categories or at all.(2) The information should be sent to the Office of Income Maintenance, Room 415, Health and Welfare Building, by the 20th of the month following the end of the calendar quarter.The provisions of this § 175.84 adopted August 4, 1977, effective 8/5/1977, 7 Pa.B. 2180. This section cited in 55 Pa. Code § 141.81 (relating to eligibility policy for Medically Needy Only).