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IEHP - Inland Empire Health Plan, A Public Entity


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Medi-Cal Benefit Manual 2007

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Introduction

Authorizations

Table of Contents

Section A
Abortion; Acquired Immune Deficiency Syndrome (AIDS); Acupuncture; Allergy Testing and Serum; Ambulance; and Apnea Monitors

Section B
Biofeedback; Blood and Blood Products; and Breastfeeding Support Services

Section C
Chemical Dependency Rehabilitation; Chemotherapy; Child Health and Disability Prevention Program (CHDP); Chiropractic; Circumsision; Corrective Appliances; and Cosmetic Surgery

Section D
Dental Services, Appliance, Oral Surgery and T.M.J; Detoxification (Substance Abuse); and Durable Medical Equipment

Section E
Early and Periodic Screening, Diagnosis and Treatment (EPSDT); Eating Disorders; Emergency Care Services; Epidural Anesthesia; and Experimental Services and Investigational Treatment

Section F
Family Planning; and Foot Care

Section G
Genetic Testing

Section H
Health Education; Hearing Aides; Hearing Screening; Hemodialysis; Home Health Care; Home use of Oxygen; Hospice Services; Hospital Services - Inpatient; Hospital Services - Outpatient; and Human Immunodeficiency Virus (HIV) testing

Section I
Immunizations/Inoculations; Impotence; Infertility; and Insulin/Syringes

Section L
Laboratory; Lithotripsy; and Long Term Care

Section M
Mammography; Mammoplasty, Reductive; Medical Supplies; Medication; and Mental Health

Section N
Newborn Child Coverage; Nutritional/Diatetic Counciling; and Nutritional Supplements and Special Formulas

Section O
Organ Transplants, Major; Ostomy Supplies; Outpatient Diagnostic Services; and Outpatient Surgery/Therapeutic Procedures

Section P
Perinatal Services; Perinatal Support Services; Phenylketonuria; Physical Examinations; Physician Services; Podiatry Services; Prayer and Spiritual Healing; Prosthetic/Orthotic Devices; and Psychiatric Hold (5150)

Section R
Radiation Therapy/Oncology; Radiology Services; Reconstructive Surgery; and Rehabilitation (P.T., O.T., Speech, Cardiac)

Section S
Skilled Nursing Facility; and Specialist

Section T
Temporomandibular Joint Dysfunction (T.M.J.); Transportation; Tuberculosis (TB)

Section V
Vision Screening; and Vision Aides (Eyeglasses, Contacts)

Section W
Waiver Programs

Appendix "A" (DME Grid)

Appendix "B" (Medical Supplies)

Index

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