Minnesota Administrative Rules

9500.1457 SERVICES COVERED BY PMAP.

Subpart 1.

In general.

Services currently available under the medical assistance program in Minnesota Statutes, section 256B.0625 and parts 9505.0170 to 9505.0475 are covered under PMAP. Chemical dependency services provided under this part must fully comply with the requirements of parts 9530.4100 to 9530.6655. The following services are not covered:

A.

case management services for serious and persistent mental illness as defined in Minnesota Statutes, section 256B.0625, subdivision 20;

B.

nursing home facility per diem services as defined in Minnesota Statutes, section 256B.0625, subdivision 2, and parts 9549.0010 to 9549.0080; and

C.

services provided under home-based and community-based waivers authorized under United States Code, title 42, section 1396.

Subp. 2.

Additional services.

A health plan may provide services in addition to those available under the medical assistance program.

Subp. 3.

Prior authorization of services.

A health plan shall be exempt from the requirements of Minnesota Statutes, chapter 256B, parts 9505.0170 to 9505.0475 and 9505.5000 to 9505.5030, that require prior authorization before providing health services to an enrollee.

Statutory Authority:

MS s 256.045; 256B.031; 256B.69

History:

11 SR 1107; 16 SR 1086

Published Electronically:

October 16, 2013