WAG 20: Medical Program

WAG 20-01-00: Medical Benefits (AFDC, AABD, GA) – 03/01/97
- WAG 20-01-01: Freedom of Choice – 03/01/97
- WAG 20-01-02: Restriction of Choice – 03/01/97
WAG 20-02-00: Persons Eligible – 07/01/97
- WAG 20-02-01: Eligibility by Program – 10/19/17 MR 17.17
- WAG 20-02-02: People in Jail – 03/01/97
- WAG 20-02-03 Automated Medical Benefit Restriction for Incarcerated Individuals – 03/23/17 MR #17.07
WAG 20-03-00: Department Responsibilities (AABD, FHP, TANF) – 07/01/13 MR 13.16
- WAG 20-03-01: Prior Approval – 07/01/00
  - WAG 20-03-01-a: Forms for Prior Approval – 12/01/09 MR 10.09
- WAG 20-03-02: Immediate Approval (Emergencies) – 03/01/97
- WAG 20-03-03: Post Approval – 03/01/97
- WAG 20-03-04: Payment – 02/05/99
  - WAG 20-03-04-a: Client Copays – 07/01/02
  - WAG 20-03-04-b: Payment of Deductibles and Coinsurance – 02/05/99
  - WAG 20-03-04-c: Services Not Covered – 02/05/99
WAG 20-04-00: Medical Providers (AABD, TANF) – 07/01/13 MR 13.16
- WAG 20-04-01: Provider Responsibilities – 03/01/97
  - WAG 20-04-01-a: Verifying Eligibility – 03/01/97
  - WAG 20-04-01-b: Record Keeping – 03/01/97
  - WAG 20-04-01-c: Billing – 03/01/97
  - WAG 20-04-01-d: Nondiscrimination – 03/01/97
- WAG 20-04-02: Provider Requirements – 03/01/97
WAG 20-05-00: Recipient Restriction Program (AABD, TANF) – 07/01/13 MR 13.16
- WAG 20-05-01: Notice of Restriction – 03/01/97
- WAG 20-05-02: Right to Appeal – 03/01/97
- WAG 20-05-03: Primary Care Providers – 03/01/97
  - WAG 20-05-03-a: Provider Duties – 03/01/97
  - WAG 20-05-03-b: Changing Primary Care Providers – 03/01/97
- WAG 20-05-04: Restriction Period – 03/01/97
- WAG 20-05-05: Reevaluating the Restriction – 03/01/97
WAG 20-06-00: Hospital (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-06-01: Providers – 03/01/97
- WAG 20-06-02 Payment – 03/01/97
  - WAG 20-06-02-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-06-02-b: Client Not Medicare Enrolled – 03/01/97
  - WAG 20-06-02-c: State Psychiatric Hospital – 07/01/13 MR 13.16
WAG 20-07-00: Physicians (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-07-01: Providers – 03/01/97
- WAG 20-07-02: Payment – 03/01/97
  - WAG 20-07-02-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-07-02-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-08-00: Long Term Care/Supportive Living (AABD) – 04/17/98
- WAG 20-08-01: Providers – 04/17/98
- WAG 20-08-02: Supportive Living Facility (SLF) Services – 04/17/98
- WAG 20-08-03: Long Term Care (LTC) Services – 04/17/98
  - WAG 20-08-03-a: Skilled Nursing Facilities (SNF) – 03/01/97
  - WAG 20-08-03-b: Intermediate Care Facilities (ICF) – 03/01/97
  - WAG 20-08-03-c Intermediate Care Facilities/Individus with Intellectual Disabilities(ICF/IID) – 03/01/97
  - WAG 20-08-03-d: Department of Human Services (DHS) Facilities – 04/01/02
- WAG 20-08-04: Screening – 02/07/13 MR 13.03
  - WAG 20-08-04-a: Second Opinion – 02/06/14 MR 14.05
  - WAG 20-08-04-b: Appeal of Screening Decision – 03/01/97
- WAG 20-08-05: Reserved – 06/01/05
- WAG 20-08-06: Reserved – 06/01/05
- WAG 20-08-07: Transfers Between Facilities – 03/01/97
  - WAG 20-08-07-a: Involuntary Transfers – 03/01/97
  - WAG 20-08-07-b: Emergency Transfers Ordered By Public Health/Healthcare and Family Services – 04/17/98
  - WAG 20-08-07-c: Transfers That Endanger Health (Long Term Care) – 04/17/98
  - WAG 20-08-07-d: Transfer From Decertified Facility – 04/17/98
- WAG 20-08-08: Voluntary Withdrawal – 04/17/98
- WAG 20-08-09: Continued Payment – 03/01/97
- WAG 20-08-10: Resident Contracts – 04/17/98
- WAG 20-08-11: Resident Funds – 04/17/98
  - WAG 20-08-11-a: Funds Managed by Client – 03/01/97
  - WAG 20-08-11-b: Funds Managed by Guardian – 03/01/97
  - WAG 20-08-11-c: Funds Managed by Facility (Long Term Care) – 06/01/05
  - WAG 20-08-11-d: Family Community Resource Center Responsibilities – 04/17/98
- WAG 20-08-12: Absence From Facility (Long Term Care) – 04/17/98
- WAG 20-08-13: Suspected Abuse and Neglect of Residents – 04/17/98
- WAG 20-08-14: Payment – 02/06/14 MR 14.05
  - WAG 20-08-14-a: Basic Rate (Long Term Care) – 04/17/98
  - WAG 20-08-14-b: Day Programming (Long Term Care) – 04/17/98
  - WAG 20-08-14-c: Exceptional Care (Long Term Care) – 01/01/07
  - WAG 20-08-14-d: Bed Reserve – 02/07/13 MR 13.03
  - WAG 20-08-14-e: DHS Facilities (Long Term Care) – 04/17/98
- WAG 20-08-15: Approval of Payment for Care – 02/07/13 MR 13.03
  - WAG 20-08-15-a: Admission Date – 08/01/01
  - WAG 20-08-15-b: Payment Approval – 02/07/13 MR 13.03
  - WAG 20-08-15-c: Application of Credits – 02/07/13 MR 13.03
  - WAG 20-08-15-d: Billing – 02/07/13 MR 13.03
  - WAG 20-08-15-e: Qualified Medicare Beneficiaries – 02/07/13 MR 13.03
  - WAG 20-08-15-f: Adjustments for Incorrect Payments – 02/07/13 MR 13.03
- WAG 20-08-16: Arranging Care after Discharge from DHS Facility – 02/07/13 MR 13.03
WAG 20-09-00: Clinics (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-09-01: Providers – 03/01/97
- WAG 20-09-02: Payment – 03/01/97
  - WAG 20-09-02-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-09-02-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-10-00: Physical Rehabilitation (TANF, AABD, GA) – 07/01/97
- WAG 20-10-01: Providers – 03/01/97
- WAG 20-10-02: Prior Approval – 03/01/97
- WAG 20-10-03: Payment – 03/01/97
WAG 20-11-00: Nurse Midwife (AFDC, AABD) – 03/01/97
- WAG 20-11-01: Providers – 03/01/97
- WAG 20-11-02: Payment – 03/01/97
- WAG 20-11-03: Prior Approval – 03/01/97
WAG 20-12-00: Home Health Care (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-12-01: Home Health Care (TANF, AABD) – 07/01/13 MR 13.16
  - WAG 20-12-01-a: Providers – 03/01/97
  - WAG 20-12-01-b: Prior Approval – 03/01/97
  - WAG 20-12-01-c: Payment – 03/01/97
- WAG 20-12-02: Reserved – 07/01/13 MR 13.16
WAG 20-13-00: Eye Care (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-13-01: Providers – 03/01/97
- WAG 20-13-02: Prior Approval – 07/01/13 MR 13.16
- WAG 20-13-03: Payment – 03/01/97
  - WAG 20-13-03-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-13-03-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-14-00: Dental Care (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-14-01: Providers – 12/01/09 MR 10.09
- WAG 20-14-02: Prior Approval – 12/01/09 MR 10.09
- WAG 20-14-03: Payment – 03/01/97
  - WAG 20-14-03-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-14-03-b: Client Not Medicare Enrolled – 12/01/09 MR 10.09
- WAG 20-14-04: Quality Control – 03/01/97
WAG 20-15-00: Podiatry (TANF, AABD, GA) – 07/01/13 MR 13.16
- WAG 20-15-01: Providers – 03/01/97
- WAG 20-15-02: Prior Approval – 03/01/97
- WAG 20-15-03: Payment – 03/01/97
  - WAG 20-15-03-a: Client Medicare Enrolled – 03/01/99
  - WAG 20-15-03-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-16-00: Chiropractic (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-16-01: Providers – 03/01/97
- WAG 20-16-02: Payment – 03/01/97
  - WAG 20-16-02-a: Client Medicare Enrolled – 03/01/99
  - WAG 20-16-02-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-17-00: Independent Laboratory and X-ray (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-17-01: Providers – 03/01/97
- WAG 20-17-02: Payment – 03/01/97
  - WAG 20-17-02-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-17-02-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-18-00: Drugs, Medical Supplies, and Sickroom Needs (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-18-01: Providers – 03/01/97
- WAG 20-18-02: Prior Approval – 03/01/97
  - WAG 20-18-02-a: Drugs – 03/01/97
  - WAG 20-18-02-b: Medical Supplies and Sickroom Needs – 03/01/97
- WAG 20-18-03: Payment – 03/21/14 MR 14.10
  - WAG 20-18-03-a: Drugs – 03/01/97
  - WAG 20-18-03-b: Medical Supplies and Sickroom Needs – 03/01/97
WAG 20-19-00: Medical Equipment and Prosthetic Devices (AFDC, AABD, GA) – 03/01/97
- WAG 20-19-01: Providers – 03/01/97
- WAG 20-19-02: Prior Approval – 03/01/97
  - WAG 20-19-02-a: Artificial Limbs and Braces – 03/01/97
  - WAG 20-19-02-b: Standard Wheelchair – 03/01/97
  - WAG 20-19-02-c: Custom Wheelchair – 03/01/97
  - WAG 20-19-02-d: Hearing Aids – 03/01/97
  - WAG 20-19-02-e: Respiratory Aids – 03/01/97
  - WAG 20-19-02-f: Standard Hospital Bed, Firm Mattress and/or Bed Board – 03/01/97
  - WAG 20-19-02-g: Special Beds, Flotation or Alternating Pressure Pads – 03/01/97
  - WAG 20-19-02-h: Custom Molded Shoes, Shoe Corrections, Shoe Braces – 03/01/97
  - WAG 20-19-02-i: Other Equipment – 03/01/97
- WAG 20-19-03: Payment – 03/01/97
  - WAG 20-19-03-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-19-03-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-20-00: Mental Health (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-20-01: Services – 03/01/97
  - WAG 20-20-01-a: Psychiatric Services (TANF, AABD) – 07/01/13 MR 13.16
  - WAG 20-20-01-b: Psychological Services (TANF, AABD) – 07/01/13 MR 13.16
  - WAG 20-20-01-c: Community Mental Health Services (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-20-02: Providers – 03/01/97
- WAG 20-20-03: Payment – 03/01/97
- WAG 20-20-04: Referrals – 03/01/97
WAG 20-21-00: Healthy Kids Program (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-21-01: Providers – 03/01/97
- WAG 20-21-02: Payment – 03/01/97
WAG 20-22-00: Transportation (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-22-01: Providers – 03/01/97
- WAG 20-22-02: Prior Approval – 10/16/01
  - WAG 20-22-02-a: Referral to DynTek – 06/01/01
  - WAG 20-22-02-b: Family Community Resource Center – 06/01/01
  - WAG 20-22-02-c: Central All Kids Unit – 06/01/01
  - WAG 20-22-02-d: Bureau of Comprehensive Health Services – 06/01/01
- WAG 20-22-03: Payment – 03/01/97
  - WAG 20-22-03-a: Public Transportation – 05/31/99
WAG 20-23-00: Renal Dialysis (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-23-01: Providers – 03/01/97
- WAG 20-23-02: Payment – 03/01/97
  - WAG 20-23-02-a: Client Medicare Enrolled – 03/01/97
  - WAG 20-23-02-b: Client Not Medicare Enrolled – 03/01/97
WAG 20-24-00: Managed Care Organization (MCO) – 01/24/2024 MR #24.03
- WAG 20-24-01: Enrolling in an MCO – 01/24/2024 MR #24.03
- WAG 20-24-02: Leaving an MCO – 01/24/2024 MR #24.03
- WAG 20-24-03: Complaints about MCOs – 01/24/2024 MR #24.03
- WAG 20-24-04: MCO Services – 01/24/2024 MR #24.03
- WAG 20-24-05: MCO Provider Assignment/Enrollment – 01/24/2024 MR #24.03
- WAG 20-24-06: MCO - Prior Approval – 01/24/2024 MR #24.03
- WAG 20-24-07: MCO - Payment – 01/24/2024 MR #24.03
WAG 20-25-00: Hospice Care (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-25-01: Providers – 03/01/97
- WAG 20-25-02: Payment – 03/01/97
WAG 20-26-00 Alcohol/Drug Abuse Treatment (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-26-01: Providers – 03/01/97
- WAG 20-26-02: Payment – 03/01/97
- WAG 20-26-03: Referrals – 03/01/97
WAG 20-27-00: Organ Transplants (TANF, AABD) – 07/01/13 MR 13.16
- WAG 20-27-01: Providers – 03/01/97
- WAG 20-27-02: Prior Approval – 03/01/97
- WAG 20-27-03: Payment – 03/01/97
WAG 20-28-00: In-home Care or Medicaid Waiver (AABD) – 03/01/97
- WAG 20-28-01: Application – 03/01/04
- WAG 20-28-02: Services – 03/01/97
- WAG 20-28-03: Fees – 03/01/97