{"ref":"MI-HH-CS-01","title":"Scope of Home Health Services","category":"Service delivery","summary":"Defines the home health services the Agency furnishes as a Medicare-certified home health agency: skilled nursing and at least one other therapeutic service, at least one of them furnished directly by Agency employees, all furnished on a visiting basis in the place the patient uses as home and in line with current clinical practice guidelines. Sets out how the Agency decides which services it offers, how services under arrangement are controlled, and what the Michigan Medicaid home health benefit covers and does not cover, so that staff do not promise, furnish or bill a service the Agency cannot provide or a payer will not cover.","inShort":["The Agency always offers skilled nursing plus at least one other service, and furnishes at least one of them with its own staff.","We furnish only the services the governing body approved and that we can staff with qualified people.","Contracted staff follow our policies, and the Agency stays responsible for their care.","Michigan Medicaid does not cover some services, such as medical social services, private duty nursing and missed visits. Check with the clinical manager before telling a patient something is covered.","Telehealth or remote monitoring never replaces an ordered home visit."],"primaryCitation":"42 CFR §484.105(f)","citations":["Michigan Medicaid Provider Manual, Home Health, Sections 1, 8, 9, 10, 12 and 13","Michigan Medicaid Provider Manual, Home Health, Section 2","Michigan Medicaid Provider Manual, Home Health, Section 11"],"federalCitations":["42 CFR §484.105(f)","42 CFR §484.105(e)","42 CFR §484.105(i)","42 CFR §484.75","42 CFR §484.80(g)","42 CFR §409.43(a)","42 CFR §409.44","42 CFR §409.45"],"surveyorAsks":["Which services do you furnish directly with your own employees, and which under arrangement?","Show me the written description of services the governing body approved and the public information you give about service limits."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.105(f))","5. Services the Agency Offers","6. Place of Service","7. Services Under Arrangement","8. Medicare Coverage Points Staff Must Know","9. Michigan Medicaid Coverage","10. Supplies and Equipment","11. Services the Agency Does Not Furnish","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"mi-hha","state":"Michigan","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}