Mich. Admin. Code R. 400.7033 - Payment for inpatient or outpatient hospitalization of migrant families
Rule 33.
(1)
Inpatient hospitalization or outpatient services for migrant families may be
provided for a period of up to 30 consecutive days in any 12-month period if
all of the following provisions are satisfied:
(a) Members of the migrant family have not
received migrant hospitalization services from the SER program in the 12-month
period preceding the date of hospital admission.
(b) The person applying for inpatient
hospitalization or outpatient services is ineligible for medicaid, and medicaid
ineligibility did not result from any of the following:
(i) Excess income.
(ii) The applicants failure to meet a
procedural requirement of medicaid.
(iii) The applicant's entrance into this
state for reasons other than employment.
(c) No member of the household quit or
refused employment or training without good cause within the 30 days prior to
application.
(2) A
migrant family is a family that meets all of the following requirements:
(a) Works primarily in agriculture or a
related seasonal industry.
(b)
Moves from place to place to find work.
(c) Lives in a temporary residence during the
work season.
(d) Has a child who is
less than 21-years-old and who is living with, or has lived with,
a specified relative during the last 6 month's.
(e) The household members are nonresidents of
this state.
(3)
Exclusions, payment rates, and conditions of coverage for inpatient
hospitalization shall be based on medicaid payment rates and covered services.
Elective hospitalization is not a covered service.
(4) Exclusions, payment rates, and conditions
of coverage for outpatient services shall be based on medicaid payment rates
and covered services subject to the following provisions:
(a) Services which are a follow-up to
inpatient services and which are performed within 30 days of the hospital
admission will be covered.
(b)
Services which are normally performed as inpatient services, but which the
attending physician and the client have decided to have performed on an
outpatient basis will be covered.
Notes
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