The executive director of the state department may authorize the providing of services of licensed psychologists without the requirement that the services be referred by a doctor of medicine or a doctor of osteopathy, but such services shall be subject to the cost containment program specified under section 25.5-4-408. The executive director may except from the authorization those services the director determines to be necessary for the purpose of promoting the primary care physician program.
Source: L. 2006: Entire article added with relocations, p. 1846, � 7, effective July 1.
Editor's note: This section is similar to former � 26-4-412 as it existed prior to 2006.
25.5-4-408. Services provided by licensed psychologists - cost containment program. (1) Working in conjunction with licensed psychologists in the state, the state board shall promulgate rules to establish and implement mechanisms for containing the costs of services provided by licensed psychologists under the medical assistance programs established pursuant to this article and articles 5 and 6 of this title. The cost containment mechanism shall ensure that the costs to the medical assistance program will result in no increase in the total cost of the program solely as a result of the reimbursement for services of licensed psychologists pursuant to section 25.5-4-407. The cost containment mechanisms may include the following:
(a) Limiting the number of days a licensed psychologist may be reimbursed per patient for inpatient hospitalization, partial hospitalization, and outpatient visits without an order for continued treatment from a doctor of medicine or osteopathy;
(b) Limiting the number of hours a licensed psychologist may be reimbursed for diagnostic testing and evaluation per patient per year;
(c) Provision of group therapy when needed or appropriate;
(d) Provision of licensed psychologists' services from a pool of those licensed psychologists requesting to be included in such pool;
(e) Provision of a licensed psychologist's services through the use of telemedicine pursuant to the provisions of section 25.5-5-320.
Source: L. 2006: Entire article added with relocations, p. 1846, � 7, effective July 1. L. 2008: (1)(e) added, p. 111, � 2, effective August 5.
Editor's note: This section is similar to former � 26-4-516 as it existed prior to 2006.
25.5-4-409. Authorization of services - nurse anesthetists - advanced practice registered nurses. (1) When services by a certified registered nurse anesthetist are provided pursuant to an order by a physician in accordance with this article 4, articles 5 and 6 of this title 25.5, and section 12-255-104 (10), the executive director of the state department shall authorize reimbursement for said services. Payment for such services shall be made directly to the nurse anesthetist, if requested by the nurse anesthetist; except that this section shall not apply to nurse anesthetists when acting within the scope of their employment as salaried employees of public or private institutions or physicians.
(2) When services by an advanced practice registered nurse registered pursuant to section 12-255-111 are provided in accordance with this article 4 and articles 5 and 6 of this title 25.5, the executive director of the state department shall authorize reimbursement for said services. Payment for the services shall be made directly to the advanced practice registered nurse, if requested by the advanced practice registered nurse; except that this section shall not apply to advanced practice registered nurses when acting within the scope of their employment as salaried employees of public or private institutions or physicians.
Source: L. 2006: Entire article added with relocations, p. 1846, � 7, effective July 1. L. 2008: (2) amended, p. 138, � 1, effective July 1. L. 2019: Entire section amended, (HB 19-1172), ch. 136, p. 1707, � 178, effective October 1.
Editor's note: This section is similar to former � 26-4-413 as it existed prior to 2006.
25.5-4-410. Services of audiologists and speech pathologists without supervision. (1) When medical or diagnostic services by an audiologist or speech pathologist are provided pursuant to an order by a physician in accordance with this article and articles 5 and 6 of this title, the executive director of the state department shall authorize reimbursement for said services. For the purposes of this section, audiologist or speech pathologist means an individual who meets the requirements set forth in the federal Social Security Act, as amended, or any federal regulations adopted pursuant thereto, for participating providers of audiology or speech pathology services.
(2) Nothing in this section shall be construed as expanding the provision of services available as a part of the medical assistance program established pursuant to this article and articles 5 and 6 of this title. For the purposes of making payments to audiologists or speech pathologists pursuant to this section, the state board shall establish rules implementing this section. The rules promulgated pursuant to this subsection (2) shall ensure that the costs to the medical assistance program will result in no increase in the total cost of the program solely as a result of the reimbursement for services of an audiologist or speech pathologist pursuant to this section.
(3) Payments for services included in this section shall be made directly to the audiologist or speech pathologist, if requested by the audiologist or speech pathologist; except that this section shall not apply to audiologists or speech pathologists when acting within the scope of their employment as salaried employees of public or private institutions or physicians.
Source: L. 2006: Entire article added with relocations, p. 1847, � 7, effective July 1.
Editor's note: This section is similar to former � 26-4-414 as it existed prior to 2006.