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Division Policy 8.06

SUBJECT

Medical Expenditures in Independent Living Adult Program (ILAP)

EFFECTIVE DATE

July 1, 2003

EXPIRATION DATE

These procedures will be reviewed and updated as needed.

REVIEW DATE

January 18, 2013

PURPOSE

Guidelines for medical expenditures using ILAP funds

AUTHORITY

FS 413, Rehabilitation Act of 1973, As Amended

POLICY

Allowable medical expenditures:

  • Diagnostics for the determination of eligibility to ILAP
  • Assessments (Low Vision Examinations) of eye conditions to determine the extent an individual can compensate for the vision deficit.

All cases determined eligible after July 1, 2003 will be guided by this procedure. Current open cases under a plan of rehabilitation will continue with services obligated in the jointly developed plan. Amendments to these plans will follow this procedure.

Procedure When Client Has Medicare or Other Insurance

  1. An authorization is written for the total DBS approved amount of the service(s). In the Special Description field of the authorization write the following: Client’s insurance MUST be billed as primary with DBS as the secondary.
  2. Once the client’s insurance has paid for their portion the vendor will send DBS an invoice AND the insurance statement indicating what was paid by insurance.
  3. DBS will only pay the difference between what the insurance covered and the DBS allowable. DBS will modify their authorization for this amount and cancel the balance.

All DBS staff should comply with these policies and procedures.

Original signed by Joyce Hildreth, Director, October 14, 2009