2013 Practitioner and Provider Manual - Presbyterian Healthcare ...

Appendix B. DefinitionsTerm Definition SourceWaiver 1915(c)NM DD (0173.R05.00)Waiver 1915(c)NM AIDS (0161.R04.00)wasteProvides case management, community integrated employment, customized communitysupports, living supports, personal support, respite, nutritional counseling, occupationaltherapy (OT) for adults, physical therapy (PT) for adults, speech and language therapy foradults, supplemental dental care, assistive technology, behavior support consultation, crisissupport, customized in-home supports, environmental mods, independent living transition,intensive medical living supports, non-medical transportation, personal support technology/onsiteresponse, preliminary risk screening and consultation related to inappropriate sexualbehavior, private duty nursing for adults, socialization and sexuality education for individualswith autism, intellectual disability (ID), DD ages 0 – no maximum age.Provides case management, homemaker/personal care, private duty nursing for individualswith HIV/AIDS ages 0 – no max age.Means an act involving payment or the attempt to obtain payment for items or services wherethere was no intent to deceive or misrepresent, but where the outcome of poor or inefficientmethods resulted in unnecessary costs to the plan.CMSCMSPM-16B-102014 Practitioner and Provider Manual - Ver. 3