Section 467-3-012 - MAJOR MEDICAL DIAGNOSIS AND SERVICESThis service provides treatment for diagnoses determined to be congenital, chronic, or prolonged, and in need of active treatment. If the applicant or recipient's diagnosis does not meet criteria for other services, the applicant or recipient may be considered for this service.
012.01MEDICAL ELIGIBILITY CONSIDERATIONS. Common diagnoses covered are Addison's disease, Turner's syndrome, hypothyroidism, esophageal strictures, imperforate anus, tracheoesophageal fistula, choanal atresia, enterocolitis, Hirschsprung's disease, aplastic anemia, gastroschisis, growth hormone deficiency, phenylketonuria, and duodenal atresia. Medically eligible immunological deficiencies are congenital hypogammaglobinemia, acquired hypogammaglobinemia, DiGeorge's syndrome, severe combined immunodeficiency, ataxia-telangiectasia syndrome, Wiskott-Aldrich syndrome, chronic granulomatous disease, Chediak-Higashi syndrome, and Kostmann's syndrome. Complement deficiencies may be considered. Not covered are growth hormone transplants of bone marrow and thymus or selective IgA deficiency, chronic mucocutaneous candidiasis, hyper IgE syndrome, and Quie-Hill syndrome. 012.01(A)MEDICAL ELIGIBILITY DETERMINATION. The medical consultant determines medical eligibility for major medical.012.01(B)CERTIFICATION DATE. The certification date is the date of referral, once medical and financial eligibility is met.012.02SERVICE COMPONENTS. Service components may be covered if recommended in the individual medical treatment plan and funds are available.467 Neb. Admin. Code, ch. 3, § 012
Adopted effective 5/17/2022