Idaho Medicaid Provider Handbook, Home Health and Hospice Services § 3.3.1

(a)

Case Law

Detsel v. Sullivan, 895 F.2d 58 (2d Cir.1990).

Skubel v. Fuoroli, 113 F.3d 330 (2d. Cir. 1997).

(b)

CMS Guidance

“Face to Face Encounter with Patient Required Before Physicians May Certify Eligibility for

Home Health Services or Durable Medical Equipment Under Medicare.” H.R. 3590, “The

Patient Protection and Affordable Care Act,” Sec. 6407 (2010). Government Printing Office,

https://www.govinfo.gov/content/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf.

State Medicaid Director Letter Olmstead Update No: 3 (2000). The Health Care Finance

Administration, https://www.medicaid.gov/Federal-Policy-

Guidance/downloads/smd072500b.pdf.

(c)

Federal Regulations

Comparability of Services for Groups, 42 CFR §440.240(b) (1981). Government Printing

Office, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-440/subpart-

B/section-440.240.

Home Health Services, 42 CFR §440.70 (2020). Government Printing Office,

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-440/subpart-A/section-

440.70.

Home Health Services, 42 CFR §441.15(c) (1998). Government Printing Office,

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-441/subpart-A/section-

441.15.

Persons to Whom Services will be Provided, 42 CFR §136.12 (2002). Government Printing

Office, https://www.ecfr.gov/current/title-42/chapter-I/subchapter-M/part-136/subpart-

B/section-136.12.

“State Plans for Medical Assistance” Social Security Act, Sec. 1902(a)(10)(D) (1935). Social

Security Administration, https://www.ssa.gov/OP_Home/ssact/title19/1902.htm.

Sufficiency of Amount, Duration, and Scope, 42 CFR §440.230 (2024). Government Printing

Office,

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-440/subpart-

B/section-440.230.

(d)

State Regulations

“Participant Eligibility.” IDAPA 16.03.26, “Medicaid Plan Benefits,” Sec. 025.01. Department

of Administration, State of Idaho,

https://adminrules.idaho.gov/rules/current/16/160326.pdf.

“Settings.” IDAPA 16.03.26, “Medicaid Plan Benefits,” Sec. 242.02. Department of

Administration, State of Idaho, https://adminrules.idaho.gov/rules/current/16/160326.pdf.