Minnesota Administrative Rules
9505.0325 NUTRITIONAL PRODUCTS.
Subpart 1.
Definition.
"Nutritional product" means a commercially formulated substance that provides nourishment and affects the nutritive and metabolic processes of the body.
Subp. 2.
Eligible provider.
To be eligible for medical assistance payment, a parenteral nutritional product must be prescribed by a physician and must be dispensed as a pharmacy service under part 9505.0340. To be eligible for medical assistance payment, an enteral nutritional product must be prescribed by a physician and supplied by a pharmacy or a medical supplier who has signed a medical supplies agreement with the department.
Subp. 3.
Payment limitation; enteral nutritional products.
Except as provided in subparts 4 and 5, an enteral nutritional product must receive prior authorization to be eligible for medical assistance payment.
Subp. 4.
Covered services; enteral nutritional products for designated health condition.
An enteral nutritional product is a covered service and does not require prior authorization if it is necessary to treat a condition listed in items A to D:
Subp. 5.
Covered services; enteral nutritional product for recipient discharged from a hospital.
An enteral nutritional product provided for a recipient being discharged from a hospital to a residence other than a long-term care facility does not require prior authorization of an initial supply adequate for 30 days or less.
Subp. 6.
Payment limitations; long-term care facilities and hospitals.
An enteral nutritional product for a recipient in a long-term care facility or hospital is not eligible for payment on a separate claim for payment. Payment must be made according to parts 9500.1090 to 9500.1140, 9549.0010 to 9549.0080, and 9553.0010 to 9553.0080.
Statutory Authority:
MS s 256B.04
History:
12 SR 624
Published Electronically:
December 2, 2013
Official Publication of the State of Minnesota
Revisor of Statutes