Idaho Medicaid Provider Handbook, Home Health and Hospice Services § 4.4.1

(a)

Federal Regulations

“Conditions of and Limitations on Payment for Services” Social Security Act, Sec. 1814(a)(7)

(1935). Social Security Administration,

https://www.ssa.gov/OP_Home/ssact/title18/1814.htm.

Condition of Participation: Core Services, 42 CFR §418.64 (2019). Government Printing

Office, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418/subpart-

C/subject-group-ECFR35b48a647589673/section-418.64.

Condition of Participation: Drugs and Biologicals, Medical Supplies, and Durable Medical

Equipment, 42 CFR §418.106 (2019). Government Printing Office,

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418/subpart-D/section-418.106.

Condition of Participation: Short-term Inpatient Care, 42 CFR §418.108 (2016).

Government Printing Office, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418/subpart-D/section-418.108.

Definitions, 42 CFR §418.3 (2021). Government Printing Office,

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418/subpart-A/section-

418.3.

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

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

“Definitions of Services, Institutions, Etc” Social Security Act, Sec. 1861(t) (1935). Social

Security Administration, https://www.ssa.gov/OP_Home/ssact/title18/1861.htm.

“Hospice Care; Hospice Program” Social Security Act, Sec. 1861(dd) (1935). Social Security

Administration, https://www.ssa.gov/OP_Home/ssact/title18/1861.htm.

“Scope of Benefits” Social Security Act, Sec. 1812(d) (1935). Social Security Administration,

https://www.ssa.gov/OP_Home/ssact/title18/1812.htm.

(b)

State Regulations

“Hospice.” IDAPA 16.03.26, “Medicaid Plan Benefits,” Sec. 650. Department of

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

Medical Assistance Program – Services to be Provided, Idaho Code 56-255(3)(g) (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://adminrules.idaho.gov/rules/current/16/160326.pdf.

“Types of Treatments and Procedures Not Covered.” IDAPA 16.03.26, “Medicaid Plan

Benefits,” Sec. 060.02.b. Department of Administration, State of Idaho,

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