10.09.22.05

.05 Limitations.

The Program does not cover the following:

A. Services not specified in Regulation .04 of this chapter;

B. Services not medically necessary;

C. Investigational and experimental drugs and procedures;

D. Drugs and supplies which are acquired at no cost;

E. Injections and visits solely for the administration of injections, unless both the participantís inability to take oral medications and medical necessity for the injections are documented in the participantís medical record;

F. Travel expenses;

G. Specimen collection, except by venipuncture and capillary or arterial puncture, as a separate service;

H. Laboratory or X-ray services performed by another facility;

I. Completion of forms and reports;

J. Broken or missed appointments; and

K. Professional services rendered by mail or telephone.