NAC442.788. Payment for dietary supplements and medications; additional covered services.


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  •      1. The program does not pay for dietary supplements or medications relating to eligible medical conditions except as otherwise provided in subsection 2 and in the circumstances specified for the following eligible medical conditions:

         (a) Cystic fibrosis, medications related to the eligible medical condition or its complications.

         (b) Epilepsy, subject to individual case and medical review.

         (c) Juvenile diabetes, subject to individual case and medical review.

         (d) Inborn errors of metabolism, including those detected through the program for screening newborn babies conducted pursuant to NRS 442.008 and NAC 442.020 to 442.050, inclusive, dietary supplements as prescribed.

         (e) Asthma that requires daily medication for a client to perform the activities of daily living, subject to individual case and medical review.

         (f) Cardiac conditions that require ongoing medication for a client to perform the activities of daily living, subject to individual case and medical review.

         (g) Thyroid conditions that require ongoing medication, subject to individual case and medical review.

         2. The program will, subject to individual case and medical review, cover dietary supplements and medications required on an ongoing basis for the prevention or amelioration of complications of an eligible medical condition.

         3. The program will cover:

         (a) Primary care of a client, as recommended by the American Academy of Pediatrics, to the extent that the Division determines such care is necessary to ensure the optimum health of the client;

         (b) Services of a licensed dietitian, to the extent that the Division determines those services are necessary to ensure the optimum health of a client;

         (c) Physical therapy necessary to return a client to functional ability, except that, unless otherwise authorized by the Division, such coverage is limited to not more than 12 sessions annually and 60 minutes per session; and

         (d) Psychological therapy relating to emotional support for an ongoing, chronic eligible medical condition, except that, unless otherwise authorized by the Division, such coverage is limited to:

              (1) For individual therapy, not more than 12 sessions annually and 60 minutes per session.

              (2) For group therapy, not more than 24 sessions annually.

     (Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98; R095-99, 11-29-99; R090-12, 12-20-2012)