PM 06-05-04 Covered Services

WAG 06-05-04


Deleted textThe period of time for which services are authorized cannot be more than 30 consecutive days.  When the emergency medical condition extends beyond 30 consecutive days, contact the Illinois Department of Healthcare and Family Services (HFS), Revised textBureau of Medical Eligibility and Special Programs (BMESP) for guidance.

Eligibility cannot be authorized for a future period. Coverage for an emergency medical condition can only be authorized after the services are provided.

Inpatient Hospital Stays

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If a noncitizen Revised textwho does not meet the federal qualifying Medicaid criteria is admitted to a hospital as a result of an emergency medical condition, eligibility for benefits will continue for the length of the medically necessary acute care hospital stay excluding the discharge date. The Client Assessment Unit (CAU) will determine whether the admission resulted from an emergency medical condition.

CAU will review medical records to determine whether the admission resulted from an emergency condition. CAU will report the length of stay in an acute care unit to the DHS Family Community Resource Center (FCRC) using discharge information provided by the hospital or attending physician. The FCRC will enroll the noncitizen for the number of days reported by CAU.