HAR §17-1737-3
HAR §17-1737-3. Inpatient hospital care
Cite as Haw. Code R. § 17-1737-3
(a)
Inpatient hospital care means services that are
ordinarily furnished in a hospital for the care and
treatment of inpatients under the direction of a
physician, podiatrist, or dentist and which is
furnished by an institution meeting the following
requirements:
(1) Is not maintained primarily for the treatment
of tuberculosis, mental diseases, or Hansen's
disease;
(2) Is licensed as a hospital by the State;
(3) Meets the requirements for medicare
participation; and
(4) Has in effect a utilization review plan
approved by the department.
(b) Inpatient hospital care shall include the
following:
(1) Ward or semiprivate accommodations including
bed and meals, or a private room when
medically indicated;
(2) Nursing care;
(3) Drugs, dressings, and diagnostic and
therapeutic procedures as prescribed by the
attending physician; and
(4) Other ancillary services associated with
hospital care except private duty nursing.
(c) The department shall not pay for inpatient
hospital care in the following instances:
(1) Patients whose medical needs do not require
admission for acute inpatient care;
UNOFFICIAL
1737-6
(2) Diagnostic procedure which may be performed
on an outpatient basis;
(3) Personal comfort items furnished by the
hospital; and (4) Partial hospitalization,
day, evening, or night care, except for a
patient receiving a surgical procedure or
test which would permit return to the
patient's home on the same
day.[Eff 08/01/94 ] (Auth: HRS §346-14)
(Imp: 42 C.F.R. §440.10)
§17-1737-4 Length of inpatient hospital care and
extension of stay. (a) The UCC of an acute hospital
facility shall determine the medical necessity for
admission and continued stay for all recipients.
(b) The length of stay for the service category
maternity after the delivery of a live newborn shall be
limited to two days after delivery for a normal
delivery and four days after delivery for a Cesarean
section delivery. Stays exceeding these limitations
must be authorized for medical necessity by the DHS's
medical consultant or its authorized representative.
(c) A request for the extension of hospital stay
shall be requested only when a patient is awaiting
placement in a long term care facility. [Eff 08/01/94]
(Auth: HRS §346-14) (Imp: 42 C.F.R. §440.230)