471 Neb. Admin. Code, ch. 34, § 003

Current through June 17, 2024
Section 471-34-003 - Covered RHC Services

NMAP covers services provided by RHC's on or after July 1, 1990, under this chapter. NMAP defines covered Rural Health Clinic services as the following services provided by a Certified Rural Health Clinic:

1. Services provided by a physician within the scope of practice under state law, if the physician performs the services in the clinic or the services are provided away from the clinic and the physician has an agreement with the clinic provided that s/he will be paid by the clinic for the services;
2. Services provided by a physician assistant, nurse practitioner, nurse midwife, or other specialized nurse practitioner if the services are provided in accordance with Medicare requirements;
3. Services and supplies that are provided as an incident to professional services provided by a physician, physician assistant, nurse practitioner, nurse midwife, or other specialized nurse practitioner;
4. Part-time or intermittent visiting nurse care and related medical supplies (other than drugs and biologicals) if -
a. The clinic is located in an area in which the Centers for Medicare and Medicaid Services has determined that there is a shortage of home health agencies;
b. The services are provided by a registered nurse or licensed practical nurse or a licensed vocational nurse who is employed by, or otherwise compensated for services by the clinic;
c. The services are provided under a written plan of treatment that is established and reviewed at least every 60 days by a physician, physician assistant, nurse practitioner, nurse midwife, or other specialized nurse practitioner and review and approved at least every 60 days by a supervising physician of the clinic; and
d. The services are provided to a "homebound" client. For the purposes of visiting nurse care, a "homebound" client is one who is permanently or temporarily confined to his/her place of residence because of a medical or health condition. The client may be considered homebound if the client leaves the place of residence infrequently. For this purpose, "place of residence" does not include a hospital or skilled nursing facility.

471 Neb. Admin. Code, ch. 34, § 003