PURPOSE: This rule limits the scope of medical services which are covered by the Medicaid program as provided to General Relief assistance recipients.

1. (1) Medical assistance coverage for General Relief (GR) assistance recipients will be limited to the following medical services:

   1. (A) Inpatient hospital services;
   2. (B) Outpatient hospital services;
   3. (C) Laboratory and X-ray services;
   4. (D) Physician services, whether furnished in the office, home, hospital, nursing home or elsewhere;
   5. (E) Drugs and medicines when prescribed by a licensed physician;
   6. (F) Emergency ambulance services;
   7. (G) Orthopedic devices, durable medical equipment (wheelchairs, walkers, etc.) and prosthetic devices excluding dentures, eyeglasses and hearing aids;
   8. (H) Home health care;
   9. (I) Ambulatory surgical care;
   10. (J) Inpatient psychiatric services other than in a psychiatric hospital.

2. (2) GR recipients will not receive medical assistance coverage for the following medical services:

   1. (A) Hearing aids and related audiology services;
   2. (B) Optometric services and eyeglasses;
   3. (C) Podiatry services;
   4. (D) Dental services and dentures;
   5. (E) Family planning;
   6. (F) Early, periodic, screening, diagnosis and treatment;
   7. (G) Nursing home care in a facility that is certified as a skilled nursing facility, as an intermediate care facility, or both;
   8. (H) Nursing home care in a facility for mental diseases; and
   9. (I) Inpatient psychiatric services in a psychiatric hospital.

AUTHORITY: section 207.020, RSMo 1986.* This rule was previously filed as 13 CSR 40- 81.181. Emergency rule filed July 15, 1981, effective Aug. 1, 1981, expired Oct. 10, 1981. Original rule filed July 15, 1981, effective Oct. 11, 1981. Amended: Filed April 17, 1987, effective Sept. 11, 1987. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993.