Residents of long-term care facilities
GA | MS | NE | NY "704. Exclusions from GBHC Participation
1. Recipients who meet any of the following conditions are excluded from participation in the GBHC plan: ...
d. Residents in a nursing facility or ICF/MR..." Georgia Agreement, page VII-1."Medicaid clients in the above categories of Medicaid eligibility are excluded from participation in HealthMACS in the following circumstances: ...
2. Client resides in a nursing facility." Mississippi Contract, page 83."ARTICLE III...
3.2.5 Excluded Clients: The following clients shall be excluded from the NHC (based on the information known to the HHS eligibility system): …
(b) Clients residing in nursing facilities and receiving custodial care, pursuant to 9.20 of this contract;
(c) Clients residing in intermediate care facilities for the mentally retarded (ICF/MR) pursuant to 471 NAC 31000…" Nebraska Contract, page 23."6.0 ENROLLMENT EXCLUSIONS
6.1 The following individuals shall be deemed ineligible for enrollment in the PCPCP...Residents of State operated psychiatric facilities and residential treatment facilities for children or youth... Participants in the Long Term Home Health Care program." New York Contract, page 17.
"ENROLLMENT EXCLUSIONS
Persons in receipt of the following Medicaid services shall be deemed ineligible for enrollment in the Contractor's plan. If an enrolled member requires receipt of such service, he/she shall be disenrolled from the Contractor's plan, except as otherwise provided below:Residential Health Care Facilities (RHCF): Person is not expected to return home... Inpatient Services in a Veterans Administration (V.A.) Facility is not reimbursed by Medicaid and therefore, the Contractor is not responsible for payment if an Enrollee seeks V.A. services without Contractor authorization. An Enrollee should be disenrolled from the Contractor's plan only if the Enrollee is not expected to return home from a V.A. facility." New York Contract, Appendix L, page 8.