Section 17-1746-16 - Excluded services The following services shall not be paid for under the capitated rate:
(1) Inpatient hospital care provided under Medicaid;(2) Ambulance or emergency transportation or both as provided under Medicaid;(3) Laboratory and X-rays, including tests ordered as part of the routine care, physical examinations or preventive care, physical examinations or preventive care provided by the PACE provider;(5) Home health services provided under Medicaid;(6) Any services which have not been authorized by the multidisciplinary team, even if the service is listed as a covered benefit;(7) Services rendered in a non-emergency setting or for a non-emergency reason without the PACE provider authorization;(8) Prescription drugs not prescribed by the PACE provider;(9) Cosmetic surgery unless required for improved functioning of a malformed part of the body resulting from an accidental injury or for reconstruction following mastectomy;(10) Experimental, medical, surgical, or other health procedures not generally available in the Hawaii area;(11) Gender alteration procedures;(13) Maternal care and pediatrics;(14) Service in any hospital for the treatment of tuberculosis or chronic medically uncomplicated drug dependency or alcoholism; and(15) Any services rendered outside of the United States.Haw. Code R. § 17-1746-16
[Eff 01/29/96] (Auth: SLH 1992, Act 211; HRS § 346-59) (Imp: HRS § 346-14; 42 C.F.R. §434.20)