Section 17b-262-841 - Service limitations(a) The department shall pay only for services listed in its fee schedule.(b) the department shall not pay separately for any services that are related to the treatment of the terminal condition for which hospice services were elected.(c) Hospice services are covered in a nursing facility only if the nursing facility has a written agreement with the provider such that the provider takes full responsibility for the professional management of the client's hospice care and the nursing facility agrees to provide room and board to the client. The agreement shall meet the requirements of 42 CFR 418.112.(d) For a client eligible for both Medicare and Medicaid, the only service payable by Medicaid is the room and board charge for a client in a nursing facility. Room and board means the facility's per diem rate that includes the services described in section 17b-262-705 of the Regulations of Connecticut State Agencies.(e) The department shall pay for only one level of care on any day.(f) Respite care is not available for a client who resides in a nursing facility, hospital or ICF/MR.(g) Bereavement counseling shall be available for the family for up to 13 months following the client's death but is not separately reimbursable.(h) Home health agency services are not covered unless they are unrelated to the terminal illness and prior authorized by the department.Conn. Agencies Regs. § 17b-262-841
Adopted effective July 7, 2009