Haw. Code R. § 17-1737-91 - General provisions

(a) Allogenic bone marrow and cadaveric corneal transplants are covered under this program.

(b) Kidney transplantations are covered under this program.

(c) Other non-experimental, non-investigational organ and tissue transplantations are covered when performed in a facility certified by Medicare for the specific transplantation and approved for medical necessity by the department's medical consultant.

(d) Transplantation shall be performed by experienced specialists with transplantation training and with established success records in an approved Medicare-certified facility with proper equipment and adequate and appropriately trained support staff, except as provided in subsection (i).

(e) Prior authorization shall be required from the department's medical consultant for all transplants.

(f) Immunosuppressive therapy shall be covered as required.

(g) If a transplant should fail or be rejected and the patient is still within the age limits for transplantation, the program's medical consultant may review the case for one additional transplantation for that patient.

(h) The program shall cover costs of tissue typing of potential donors and cost of acquisition of the tissue or organ as well as other studies necessary to determine the appropriateness of the procedure and any post transplantation follow-up evaluations as required.

(i) When approved by the department's medical consultant, a patient may be treated at an appropriate out-of-state Medicare-certified transplant center for the authorized procedure.

Notes

Haw. Code R. § 17-1737-91

[Eff 08/01/94; am 11/25/96] (Auth: HRS § 346-14; 42 C.F.R. §431.10) (Imp: 42 C.F.R. §440.230; 42 U.S.C. §1396 b(i) )