Section 467-3-017 - PREMATURE BIRTHS DIAGNOSIS AND SERVICESThis service provides treatment for certain premature infants with medical complications and must be referred to other available resources or programs that assist with this population.
017.01MEDICAL ELIGIBILITY CONSIDERATIONS. Medical eligibility is based on seriousness of the condition for each applicant or recipient. Covered diagnoses may include bronchopulmonary dysplasia and hyaline membrane disease or respiratory distress syndrome when the infant has been on mechanical ventilation for more than five days. Certain other conditions associated with prematurity may be considered. Diagnoses not covered are meconium aspiration, neonatal sepsis, hypoglycemia, and neonatal meningitis. Low birth weight and gestational age alone are not medically eligible. Hospitalizations for acute care or weight gain are not medically eligible.017.01(A)MEDICAL ELIGIBILITY DETERMINATION. The medical consultant determines medical eligibility for premature births. All inpatient hospitalization discharge summaries are required.017.01(B)CERTIFICATION DATE. The certification date is the date of birth, if referred within 30 days of the date of birth, once medical and financial eligibility is met. If the referral is not made within the 30 days of birth, the certification date is the date of referral, once medical and financial eligibility is met.017.02SERVICE COMPONENTS. Service components may be covered if recommended in the individual medical treatment plan and funds are available.467 Neb. Admin. Code, ch. 3, § 017
Adopted effective 5/17/2022