PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.

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1) for statistical purposes if released in a manner that prevents the identification of any person; 2) with the consent of each person identified in the information; 3) to medical personnel, appropriate state agencies, or county and district courts to comply with this section and related rules pertaining to the control and treatment of communicable diseases and health conditions; 4) to appropriate Federal agencies, such as the Centers for Disease Control of the United States Public <strong>Health</strong> Service, but the information must be limited to the name, address, gender, race, and occupation of the patient, the date of disease onset, the probable source of infection, and other requested information about the case or suspected case of a communicable disease or health condition; or, 5) to medical personnel to the extent necessary in a medical emergency to protect the health or life of the person identified in the information. In case of sexually transmitted disease involving a minor under 13 years of age, information can not be released, except that the child’s name, age, and address and the name of the disease can be released to appropriate agents as required by Chapter 261, Family Code. If that information is required in a court proceeding involving child abuse, the information shall be disclosed in camera. A State or public health district officer or employee, local health department officer or employee, local health department officer or employee, or health authority can not be examined in a civil, criminal, special, or other proceeding as to the existence or contents of pertinent records of, or reports or information about, a person examined or treated for a reportable disease by the public health district, local health department, or health authority without that person’s consent. Acts 1989, 71 st Leg., ch.678, Sec.1,1989 Amended by Acts 1995, 74 th Leg.,ch 76, sec.5.95(90),eff./ September 1, 1995; Acts 1997,75 th Leg.,ch.165,Section 7.39,effective September 1, 1997. The Board shall: 113 Section 81.048. Notification of Emergency Personnel, Peace Officers, and Fire Fighters. 1) designate certain reportable diseases for notification under this section; and, 2) define the conditions that constitute possible exposure to those diseases. Notice of a positive test result for a reportable disease shall be given to an emergency medical service personnel, peace officer, or fire fighter as provided by this section if: 1) the emergency medical service personnel, peace officer, or fire fighter delivered a person to a hospital as defined by Section 1.03, Medical Liability and Insurance Improvement Act of Texas (Article 4590I, Vernon’s Texas Civil Statues); 2) the hospital has knowledge that he person has a reportable disease and has medical reason to believe that the person had the disease when the person was admitted to the hospital; and, 3) the emergency medical service personnel, peace officer, or fire fighter was exposed to the reportable disease during the course of duty. Notice of the possible exposure shall be given: 1) by the hospital to the local health authority: 2) by the local health authority to the director of the appropriate department of the entity that employs the emergency medical service personnel, peace officer, or fire fighter; and,
3) by the director to the employee affected. A person notified of possible exposure under this section shall maintain the confidentiality of the information as provided by this chapter. A person is not liable for good faith compliance with this section. This section does not create a duty for a hospital to perform a test that is not necessary for the medical management of the person delivered to the hospital. Acts 1989, 71 st Leg., ch 678,Section 1,effective September 1, 1989 Section 81.051. Partner Notification Programs; HIV Infection The department shall establish programs for partner notification and referral services. The partner notification services offered by health care providers participating in a program shall be made available and easily accessible to all persons with clinically validated HIV positive status. If a person with HIV infection voluntary discloses the name of a partner, that information is confidential. Partner names can be used only for field investigation and notification. An employee of a Partner Notification Program shall make the notice. The employee shall inform the person who is named as a partner of the: 1) methods of transmission and prevention of HIV infection; 2) phone numbers and addresses of HIV antibody testing sites; and 3) existence of local HIV support groups, mental health services, and medical facilities. The employee can not disclose: 1) the name of or other identifying information concerning the identity of the person who gave the partner’s name; 2) the date or period of the partner’s exposure. If the person with HIV infection also makes the notification, the person should provide the information necessary. A Partner Notification Program shall be carried out as follows: 1) A Partner Notification Program shall make the notification of a partner of a person with HIV infection in the manner authorized by this section regardless of whether the person with HIV infection who gave the partner’s name consents to the notification 2) A health care professional shall notify the Partner Notification Program when the health care professional knows the HIV positive status of a patient, and the health care professional has actual knowledge of possible transmission of HIV to a third party. Such notice shall be carried out in the manner authorized in this section and Section 81.103. A health care professional who fails to make the notice is immune from civil or criminal liability for failure to make that notice. A Partner Notification Program shall provide counseling, testing, or referral services to a person with HIV infection regardless of whether the person discloses the names of any partners. 114
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Parkland KIDSfirst, Parkland CHIP P
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Notification of Change in Provider
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CLAIMS SUBMISSION .................
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Quick Reference Checklist This manu
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Plan specified services. However, c
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CHIP Covered Services PCHP provides
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• Surgical implants • Other art
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Outpatient Mental Health Services I
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• Out-of-network services not aut
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CHIP Perinatal Covered Services Cov
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15 Covered Benefit CHIP Perinate Ne
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Covered Benefit CHIP Perinate Newbo
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• Personal comfort items includin
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• Donor non-medical expenses •
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SUPPLIES COVERED EXCLUDED COMMENTS/
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SUPPLIES COVERED EXCLUDED COMMENTS/
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Coordination between Physical and B
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in the provision of care and servic
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statement indicating that members s
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As the Primary Care Provider you mu
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Other Access Standards Service Stan
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Members Right to Select Network Oph
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HMO/Provider Coordination PCHP will
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45 • describe the range of medica
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Coordination of Care The Primary Ca
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Coordination with Texas Department
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Presentation at Emergency Room afte
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If the complaint is received verbal
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Expedited Appeal can be made verbal
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CHIP Eligibility CHIP KidsFirst Mem
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• Information concerning the grie
Page 69 and 70: Parkland Community Health Plan Memb
Page 71 and 72: Pregnant Teens Please call Parkland
Page 73 and 74: your income. Co-payments do not app
Page 75 and 76: Member’s Right to Designate an OB
Page 77 and 78: 70 To report providers use this add
Page 79 and 80: 5. Network providers must report an
Page 81 and 82: To request to be a Specialist servi
Page 83 and 84: • OB/Gyn • Periodic Health Chec
Page 85 and 86: The table below provides HHSC Manag
Page 87 and 88: CHIP Cost Sharing Caps Members rece
Page 89 and 90: of these two dates: July 18, 2007,
Page 91 and 92: (DD) Diagnosis code by specific ser
Page 93 and 94: (PP) Attending physician ID (UB-04,
Page 95 and 96: (2) post-partum visits within 60 da
Page 97 and 98: CHIP Member Enrollment and Disenrol
Page 99 and 100: • In order to synchronize all CHI
Page 101 and 102: Provider Participation Requirements
Page 103 and 104: • Evidence of state licensure, an
Page 105 and 106: U1 U2 U3 Medically necessary delive
Page 107 and 108: PROCEDURE DESCRIPTION PROCEDURE COD
Page 109 and 110: provider actually treating the memb
Page 111 and 112: themselves appropriately and follow
Page 113 and 114: Medical Record Standards The medica
Page 115 and 116: 1. History and Physical Examination
Page 117 and 118: WIC services include providing nutr
Page 119: As soon as the member knows they wi
Page 123 and 124: In addition to the previously state
Page 125 and 126: Prior Authorization The CHIP Perina
Page 127 and 128: Appendix A Universal Referral/Prior
Page 129 and 130: Appendix B Consent for Disclosure 1
Page 131 and 132: PERMISSION TO RELEASE CONFIDENTIAL
Page 133 and 134: EXAMPLE FORM PRIVATE PAY AGREEMENT
Page 135 and 136: Appendix D Clinical Practice Guidel
Page 137 and 138: Appendix D - Continued Clinical Pra
Page 139 and 140: Appendix D - Continued Clinical Pra
Page 141 and 142: RATIONALE: Attention-Deficit/ Hyper
Page 143 and 144: Appendix G Urinary Tract Infections
Page 145 and 146: Follow-up • Follow-up urine cultu
Page 147 and 148: RATIONALE: Prevention of RSV Illnes
Page 149 and 150: RATIONALE: Treatment of Group A Str
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PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.

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