(1) A visit is a personal contact in the place of residence of a patient made for the purpose of providing a covered service by a health worker on the staff of a certified Medicaid home health agency.
- (a) Home health care visits to Medicaid recipients must be medically necessary and in accordance with a Medicaid Home Health Certification form established by a licensed physician or non-physician practitioners (NPP). Home Health records are subject to onsite audits and desk reviews by the professional staff of the Alabama Medicaid Agency.
- (b) Home health care visits are limited to one hundred four (104) per calendar year.
- (2) If a Medicaid recipient receiving home health visits is institutionalized and is referred to home health upon discharge from the institution, a new Medicaid Home Health Certification form must be completed and retained by the home health agency.
Author: Ruth Chambliss, Christine Luna, Theresa D. Richburg
Statutory Authority: Title XIX, Social Security Act; 42 C.F.R.
§441.15; State Plan.
History: Rule effective October 1, 1982. Amended effective July 8, 1983; January 8, 1986; January 13, 1988; February 9, 1989. Amended: Published October 30, 2020; effective December 14, 2020.