Iowa Admin. Code r. 641-88.5 - Covered health care services
An
(1) Covered health care services are only
those that are:
a. Identified in the
protection agreement with the VHCPP ;
b. In compliance with these rules;
c. Provided by or under the direct
supervision of the individual volunteer health care provider ;
d. Health care services of:
(1) Advanced registered nurse practitioners
for: well-child examinations; annual adult examinations; diagnosis and
treatment of acute and chronic conditions; health education; health
maintenance; immunizations; and minor surgical procedures. Certified registered
nurse anesthetists may provide anesthesia services for major surgical
procedures only if the following conditions are satisfied:
1. The surgery is performed in a hospital as
defined in Iowa Code section
135B.1(3) or
an outpatient surgical facility ;
2.
The hospital or outpatient surgical facility at which the surgery is performed
has executed a sponsor entity agreement ;
3. The physician performing the surgery
provides or assures the provision of adequate presurgical and postsurgical
care, including any follow-up necessary to address postoperative complications;
and
4. The physician performing the
surgery is an individual specialty health care provider or part of a group of
specialty health care providers which has registered with the department as a
specialty health care provider office .
(2) Audiologists for: testing, measurement
and evaluation related to hearing and hearing disorders and associated
communication disorders for the purpose of nonmedically identifying,
preventing, modifying or remediating such disorders and conditions including
the determination and use of appropriate amplification; patient
instruction/counseling; patient habilitation/rehabilitation; and
referrals.
(3) Bachelor social
workers for: psychosocial assessment and intervention through direct contact
with clients; referral to other qualified resources for assistance; performance
of social histories; problem identification; establishment of goals and
monitoring of progress; interviewing techniques; counseling; social work
administration; supervision; evaluation; interdisciplinary consultation and
collaboration.
(4) Chiropractors
for: examinations; diagnosis and treatment; health education; and health
maintenance.
(5) Dental assistants
for: intraoral services; extraoral services; infection control; radiography;
and removal of plaque or stain by toothbrush, floss, or rubber cup coronal
polish.
(6) Dental hygienists for:
assessments and screenings; health education; health maintenance; and
preventive services (cleaning, X-rays, sealants, fluoride treatments, fluoride
varnish).
(7) Dentists for: dental
examinations; diagnosis and treatment of acute and chronic conditions; health
education; health maintenance; and minor surgical procedures.
(8) Emergency medical care providers for:
airway/ventilation/oxygenation; assisted medications -patient 's;
cardiovascular/circulation; immobilization; IV initiation/maintenance/fluids;
and medication administration - routes.
(9) Independent social workers for:
psychosocial assessment, diagnosis, and treatment; performance of psychosocial
histories; problem identification; evaluation of symptoms and behavior;
assessment of psychosocial and behavioral strengths and weaknesses and effects
of the environment on behavior; psychosocial therapy; differential treatment
planning; and interdisciplinary consultation.
(10) Licensed practical nurses for:
supportive or restorative care.
(11) Marital and family therapists for:
marital and family therapy; and application of counseling techniques in the
assessment and resolution of emotional conditions.
(12) Master social workers for: psychosocial
assessment, diagnosis, and treatment; performance of psychosocial histories;
problem identification; evaluation of symptoms and behavior; assessment of
psychosocial and behavioral strengths and weaknesses and effects of the
environment on behavior; psychosocial therapy; differential treatment planning;
and interdisciplinary consultation.
(13) Mental health counselors for: mental
health counseling; and counseling services involving assessment, referral and
consultation.
(14) Occupational
therapists for: evaluation and treatment of problems interfering with
functional performance in persons impaired by physical illness or injury,
emotional disorder, congenital or developmental disability or the aging
process.
(15) Optometrists for:
examinations; diagnosis and treatment of the human eye and adnexa; health
education; and health maintenance.
(16) Pharmacists for: drug dispensing;
patient counseling; health screenings and education; and
immunizations.
(17) Physical
therapists for: interpretation of performance, tests, and measurements;
evaluation and treatment of human capabilities and impairments; use of physical
agents, therapeutic exercises, and rehabilitative procedures to prevent,
correct, minimize, or alleviate a physical impairment; establishment and
modification of physical therapy program; treatment planning; and patient
instruction/education.
(18)
Physicians and physician assistants for: well-child examinations; annual adult
examinations; diagnosis and treatment of acute and chronic conditions; health
education; health maintenance; immunizations; and minor surgical procedures.
Physicians may perform major surgical procedures only if the following
conditions are satisfied:
1. The surgery is
performed in a hospital as defined in Iowa Code section
135B.1(3) or
an outpatient surgical facility ;
2.
The hospital or outpatient surgical facility at which the surgery is performed
has executed a sponsor entity agreement ;
3. The physician provides or assures the
provision of adequate presurgical and postsurgical care, including any
follow-up necessary to address postoperative complications; and
4. The physician performing the surgery is an
individual specialty health care provider or part of a group of specialty
health care providers which has registered with the department as a specialty
health care provider office .
(19) Podiatrists for: examinations; diagnosis
and treatment; health education; health maintenance; and minor surgical
procedures.
(20) Psychologists for:
counseling and the use of psychological remedial measures with persons with
adjustment or emotional problems.
(21) Registered nurses for: well-child
examinations; annual adult examinations; treatment of acute and chronic
conditions; health education; health maintenance; and immunizations.
(22) Respiratory therapists for: diagnostic
and therapeutic use of administration of medical gases, aerosols, and
humidification, not including general anesthesia; pharmacologic agents relating
to respiratory care procedures; bronchopulmonary hygiene; specific diagnostic
and testing techniques employed in the medical management of patients to assist
in diagnosis, monitoring, treatment, and research of cardiopulmonary
abnormalities; and pulmonary function testing.
(23) Speech pathologists for: testing,
measurement and evaluation related to the development and disorders of speech,
fluency, voice or language for the purpose of nonmedically preventing,
ameliorating, modifying or remediating such disorders and conditions; patient
instruction/counseling; patient habilitation/rehabilitation; and
referrals.
(2) Experimental procedures or procedures and
treatments which lack sufficient evidence of clinical effectiveness are
excluded from the VHCPP
Notes
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