STATE AND DEPARTMENTAL PURCHASING PROCEDURE
Children’s Specialists must follow applicable departmental, divisional, and agency purchasing policies and procedures when purchasing goods or services for CS clients.
Children’s Specialists must authorize services and approve rate of payment in accordance with the policies established by RSB.
RSB will establish a case service limit for each Children’s Specialist on an annual basis at the beginning of the State Fiscal Year. Children’s Specialists may not authorize any purchase that will exceed their annual limit without the written approval of the Deputy Director, RSB.
Purchases may be made by Children’s Specialists for individual case services/equipment, or for common “loan closet” equipment to be managed by the Children’s Specialist.
AUTHORIZATION FOR SERVICES
Children’s Specialists will ensure that an authorization is written before or at the same time any service is purchased or provided.
An authorization may be written prior to eligibility only for purposes of examinations necessary for eligibility purposes.
All authorizations will be coded with the specific Children’s Services code.
COMPARABLE SERVICES AND BENEFITS
The Children’s Services program requires clients to utilize comparable services and benefits for all applicable services. A comparable service or benefit is any resource which may provide equipment and/or services similar to those provided by the CS program. Some examples which must be considered include: Medicare, Medicaid, health insurance, Missouri Telecommunication Access Program (TAP), Independent Living Centers, or any other comparable service or benefits available to the client. CS staff are encouraged to use comparable benefits whenever possible. Consideration and use of comparable services or benefits is documented in the narrative and authorization.
FOR MEDICARE RECIPIENTS, the CS program may pay the deductible and co-insurance amount (including any difference between Medicare reimbursement and allowable cost) up to the fee schedule after all other resources have been exhausted.
Consideration and Utilization for Diagnostic Exams
CS staff are required to consider comparable services and benefits for all diagnostic exams, including those intended for use in eligibility determination.