12 Va. Admin. Code § 30-120-630

Current through Register Vol. 41, No. 6, November 4, 2024

Section 12VAC30-120-630 - Covered services

A. The MCO shall, at a minimum, provide all medically necessary Medicaid covered services required under the state plan (12VAC30-50-10 through 12VAC30-50-310, 12VAC30-50-410 through 12VAC30-50-430, and 12VAC30-50-470 through 12VAC30-50-580 ) and Elderly and Disabled with Consumer Direction waiver regulations (12VAC30-120-924 and 12VAC30-120-927 ) and the Technology Assisted waiver regulations (12VAC30-120-1720 ) and, effective January 1, 2018, community mental health services (12VAC30-50-130 and 12VAC30-50-226 ).

B. The following services are not covered by the MCO and shall be provided through fee-for-service outside the CCC Plus MCO contract:

1. Dental services (12VAC30-50-190 );

2. School health services (12VAC30-50-130 );

3. Preadmission screening (12VAC30-60-303 );

4. Individual and Developmental Disability Support waiver services (12VAC30-120-700 et seq.);

5. Intellectual Disability Waiver (12VAC30-120-1000 et seq.); or

6. Day Support Waiver (12VAC30-120-1500 et seq.).

C. The Program of All-Inclusive Care for the Elderly, or PACE, is not available to CCC Plus members.

12 Va. Admin. Code § 30-120-630

Derived from Virginia Register Volume 37, Issue 14, eff. 3/31/2021.

Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.