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planning and ensuring that the covered person receives the | services ordered by the physician; |
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| E.__Has under contract the services of a physician or a | physician-advisor licensed by the State; |
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| F.__Conducts periodic case conferences for the purpose of | individualized patient care planning and utilization review; | and |
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| G.__Maintains a complete medical record on each patient. |
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| | 5. Home health care services. "Home health care services" | has the same meaning as set forth in section 2745, subsections 1 | and 2, except that the requirements of section 2745, subsection | 1, paragraph A shall not apply means those health care services | rendered in a person's place of residence on a part-time basis to | a covered person only if the plan covering the home health | services is established as prescribed in writing by a physician. |
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| There is no requirement that hospitalization be an antecedent to | coverage under the policy.__"Home health care services" includes: |
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| A.__Visits by a registered nurse or licensed practical nurse | to carry out treatments prescribed or supportive nursing | care and observation as indicated; |
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| B.__A physician's home or office visits or both; |
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| C.__Visits by a registered physical, speech, occupational, | inhalation or dietary therapist for services or for | evaluation of, consultation with and instruction of nurses | in carrying out therapy prescribed by the attending | physician, or both; |
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| D.__Any prescribed laboratory tests and x-ray examination | using hospital or community facilities, drugs, dressings, | oxygen or medical appliances and equipment as prescribed by | a physician, but only to the extent that such charges would | have been covered under the contract if the covered person | had remained in the hospital; and |
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| E.__Visits by persons who have completed a home health aide | training course under the supervision of a registered nurse | for the purpose of giving personal care to the patient and | performing light household tasks as required by the plan of | care, but not including services. |
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