[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR440.185]



[Page 261]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 440_SERVICES: GENERAL PROVISIONS--Table of Contents

 

                          Subpart A_Definitions

 

Sec.  440.185  Respiratory care for ventilator-dependent individuals.



    (a) ``Respiratory care for ventilator-dependent individuals'' means 

services that are not otherwise available under the State's Medicaid 

plan, provided on a part-time basis in the recipient's home by a 

respiratory therapist or other health care professional trained in 

respiratory therapy (as determined by the State) to an individual who--

    (1) Is medically dependent on a ventilator for life support at least 

6 hours per day;

    (2) Has been so dependent for at least 30 consecutive days (or the 

maximum number of days authorized under the State plan, whichever is 

less) as an inpatient in one or more hospitals, NFs, or ICFs/MR;

    (3) Except for the availability of respiratory care services, would 

require respiratory care as an inpatient in a hospital, NF, or ICF/MR 

and would be eligible to have payment made for inpatient care under the 

State plan;

    (4) Has adequate social support services to be cared for at home;

    (5) Wishes to be cared for at home; and

    (6) Receives services under the direction of a physician who is 

familiar with the technical and medical components of home ventilator 

support, and who has medically determined that in-home care is safe and 

feasible for the individual.

    (b) For purposes of paragraphs (a)(4) and (5) of this section, a 

recipient's home does not include a hospital, NF, ICF/MR or other 

institution as defined in Sec.  435.1010 of this chapter.



[59 FR 37717, July 25, 1994, as amended at 71 FR 39229, July 12, 2006]