(1) The medically intensive children's program (MICP) provides private duty nursing to clients, either through fee-for-service or an agency-contracted managed care organization (MCO).
(2) The MICP is available to clients age seventeen and younger, whose complex medical needs cannot be managed within the scope of intermittent home health services.
(3) Managed care clients receive private duty nursing services through their agency-contracted MCO. (See chapter 182-538
WAC). Providers must follow the policies and procedures of the client's MCO, including the authorization of services.
(4) For clients with third-party liability (TPL) coverage (see WAC 182-500-0105
) that includes private duty nursing, the procedures and policies in subchapter III, titled Private Duty Nursing, apply when determining coverage of additional hours under MICP.
[Statutory Authority: RCW 41.05.021
. WSR 18-15-010, § 182-551-3000, filed 7/6/18, effective 9/1/18. WSR 11-14-075, recodified as § 182-551-3000, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050
, and 74.09.700
. WSR 06-24-036, § 388-551-3000, filed 11/30/06, effective 1/1/07. Statutory Authority: RCW 74.08.090
. WSR 01-05-040, § 388-551-3000, filed 2/14/01, effective 3/17/01.]