102 EAST LIBERTY STREET
BENNETTSVILLE, SC 29512
AFTER HOURS CRISIS
MEDICAID TARGETED CASE MANAGEMENT
Targeted case management is a service that assists beneficiaries in gaining and coordinating access to necessary medical, social, and educational care and other services appropriate to their needs. It is intended for beneficiaries who do not reside in institutions. The service may be provided as an integral and essential complement to another covered service, such as a home health agency nurse’s preparation of a treatment plan. It may be provided by Medicaid agency staff through utilization review, prior approval or other administrative activities. It may also be provided as a separate service by appropriately qualified case managers. The Targeted Case Management Services table reflects only those instances where the service is separately provided.
A majority of the states make the service available to at least one group, and several states offer targeted case management services to a number of different groups, including: • Beneficiaries with specific conditions or reportable communicable diseases such as cerebral palsy, epilepsy, asthma, diabetes, sickle cell anemia, hemophilia, traumatic brain injury, dementia, HIV/AIDS, or tuberculosis;
• Elderly or disabled beneficiaries of any age at risk of institutionalization due to multiple physical or mental diagnoses, including those who are medically fragile, technology dependent, and/or with costly health care needs;
• Severely emotionally disturbed or neurologically impaired children;
• Beneficiaries of varying ages with substance abuse problems, chronic mental illness and/or developmental disabilities, including those who may be transitioning to community placement;
• At risk pregnant women, or young mothers and their infants;
• Children with high blood lead levels;
• Beneficiaries with severe vision or other sensory impairments;
• Children in foster care or state custody or who are at risk of out of home placement;
• Beneficiaries of any age at risk of abuse or neglect; or
• Refugees or immigrants having difficulty accessing health care due to language proficiency.Type your paragraph here.