My WebLink
|
Help
|
About
|
Sign Out
Browse
Search
Healthcare for Offenders Housed in Non-Idaho Department of Correction Facilities
IDOC
>
Policies & Forms
>
Policies
>
400 - Operational Services
>
Healthcare for Offenders Housed in Non-Idaho Department of Correction Facilities
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/31/2024 1:39:45 PM
Creation date
1/5/2018 11:21:12 PM
Metadata
Fields
Template:
Policies & Forms
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
9
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
Download electronic document
Show annotations
View images
View plain text
Control Number: <br />401.06.03.087 <br />Version: <br />2.1 <br />Title: <br />Healthcare for Offenders Housed in <br />Non-Idaho Department of Correction <br />Facilities <br />Page Number: <br />5 of 7 <br /> <br />Category 4—Limited Medical Value <br />This category includes medical conditions in which treatment provides little or no <br />medical value, is not likely to provide substantial long-term gain, or is expressly for <br />cosmetic purposes for the offender’s convenience. <br />Examples of conditions considered a category 4 include, but are not limited to: <br />Cosmetic/Acne Treatments <br />• Face cream, lotion, or wash of any kind; <br />• Acne cream, lotion, or wash of any kind; and <br />• Antibiotics for acne. <br />Supplements <br />• Vitamin or herbal supplements of any kind. <br />Nail Fungus <br />Insomnia <br />Miscellaneous <br />• Shoe inserts, <br />• Special footwear, <br />• Special shampoo, and <br />• Chiropractic care. <br />Dental <br />• Prosthetics, <br />• Night or occlusal guards, <br />• Teeth cleaning, and <br />• Root canals. <br />Note: A medical condition in this category does require approval from the health <br />authority prior to providing treatment; however, please be advised that only on rare <br />occasions will conditions in this category receive approval. Submit Appendix A, Medical <br />Request for Payment Authorization, to the Health Services staff. Any item or treatment in <br />this category that is recommended by a healthcare provider may be referred to the <br />health authority for review. The referral must include documentation from the licensed <br />medical provider stating that the item or treatment is medically necessary. <br />Non-category—Dental Conditions or Optometry Care <br />This category includes guidelines and the criteria for approving dental conditions or <br />optometry care that does not fit into any of the four (4) categories listed above.
The URL can be used to link to this page
Your browser does not support the video tag.