Idaho Medicaid Provider Handbook, Home Health and Hospice Services § 3.4.1

(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

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

“Definitions.” Social Security Act, Sec. 1905(a)(7) (1935). Social Security Administration,

https://www.ssa.gov/OP_Home/ssact/title19/1905.htm.

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 (1998). Government Printing Office,

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

441.15.

(d)

State Plan

Basic Alternative Benefit Plan. Division of Medicaid, Department of Health and Welfare, State

of Idaho,

http://www.healthandwelfare.idaho.gov/Portals/0/Medical/MedicaidCHIP/BasicBenchmark.p

df.

(e)

State Regulations

“Home Health: Coverage and Limitations.” IDAPA 16.03.26, “Medicaid Plan Benefits,” Sec.

242. Department of Administration, State of Idaho,

https://proddfmmainsa.blob.core.windows.net/dfm-admin-

website/rules/current/16/160326.pdf.

“Home Health Services: Procedural Requirements.” IDAPA 16.03.26, “Medicaid Plan

Benefits,” Sec. 243 Department of Administration, State of Idaho,

https://proddfmmainsa.blob.core.windows.net/dfm-admin-

website/rules/current/16/160326.pdf.

Medical Assistance Program – Services to be Provided, Idaho Code 56-255(3)(f) (2018).

Idaho State Legislature,

https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-255.

“Medical Necessity (Medically Necessary).” IDAPA 16.03.26, “Medicaid Plan Benefits,” Sec.

006.15. Department of Administration, State of Idaho,

https://proddfmmainsa.blob.core.windows.net/dfm-admin-

website/rules/current/16/160326.pdf.

Rulemaking Authority, Idaho Code 56-264 (2012). Idaho State Legislature,

https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-264.

“Therapy Services: Procedural Requirements.” IDAPA 16.03.26, “Medicaid Plan Benefits,”

Sec. 253. Department of Administration, State of Idaho,

https://proddfmmainsa.blob.core.windows.net/dfm-admin-

website/rules/current/16/160326.pdf.