La. Admin. Code tit. 50 § XXI-2305

Current through Register Vol. 50, No. 11, November 20, 2024

Section XXI-2305 - Plan of Care

A.The applicant and support coordinator have the flexibility to construct a plan of care (POC) that serves the participants health, safety and welfare needs. The service package provided under the POC shall include services covered under the Adult Day Health Care Waiver, Medicaid State Plan services, and any other services, regardless of the funding source.

1. All services approved pursuant to the POC shall be medically necessary and provided in a cost-effective manner.

2. The POC shall be developed using a person-centered process coordinated by the support coordinator.

B. Reimbursement shall not be made for adult day health care waiver services provided prior to the department's, or its designee's, approval of the POC.

C. The POC shall contain the:

1. types and number of services (including waiver and all other services) necessary to reasonably assure health and welfare and to maintain the individual in the community;

2. individual cost of each waiver service; and

3. total cost of waiver services covered by the POC.

La. Admin. Code tit. 50, § XXI-2305

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 39:2496 (September 2013), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 442164 (12/1/2018).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.