PDN Prior Authorization Adjustment Including Urgent or Emergency Situations

Private Duty Nursing (PDN) Prior Authorization Adjustment Including Urgent Or Emergency Situations

There are times when one PDN agency cannot staff all the PDN services authorized for a participant. The Bureau of Special Health Care Needs (BSHCN) service coordinator may approve services to multiple provider agencies or a different agency to meet the participant's needs. The services must be prior authorized for each provider agency, with a specific number of units authorized to each agency based on the anticipated services each agency will provide.

PACE Benefit Table

Program of All-Inclusive Care for the Elderly (PACE) Benefit Table

The Program of All-Inclusive Care for the Elderly (PACE) is administered by MO HealthNet and Medicare to provide comprehensive health care, social, recreational, and wellness services to its participants. One of the main goals of PACE is to allow older adults to live safely in their homes instead of nursing facilities. As of May 3, 2024, PACE organizations are active in St. Louis and Kansas City, with a new PACE organization coming to the Springfield area later this year.

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