§ 1247.53. Limitations on payment.
(a) The Department’s coverage for targeted case management services is limited to a specified number of hours per 30-day period as determined by the Department as appropriate for the specific target group, and included in the MA Program Fee Schedule.
(b) Payment will be made for targeted case management services provided by only one MA case manager per recipient for a given period of time, which will be determined by the Department.
(c) Coverage for targeted case management services is limited to recipients identified by the Department as belonging to a group targeted for case management services.
(d) The Department reserves the right to limit a case manager MA caseload.
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