CMISP Covered Services


Scope of services for the Sacramento County Medically Indigent Program shall not exceed the Scope of Service provided by the Medi-Cal Act as contained in Chapter 7, Part 3, Division 9, Welfare & Institution Code, et. seg.  Unless otherwise specifically described, these services are available only when provided by County staff or authorized by Sacramento County Medical Case Management services under the auspices of the program.  All such services must be received in a hospital, clinic, or health facility designated by the program, and are subject to utilization controls.
 
Care in Primary Care Clinics and Medical Offices:
 
  1. Primary physician services - medical services, including, but not limited to, diagnosis and treatment, outpatient surgical procedures, and emergency care.
  2. Specialist care on referral, including diagnostic consultation, short-term treatment services, long-term management of specific health problems.
  3. Some diagnostic, x-rays, and laboratory tests.
  4. Short-term physical/occupational therapy, casts, dressings, minor surgery and injected medications.
 
Hospital Care:
 
  1. Inpatient, outpatient or surgical treatment center facilities.
  2. Physician services, including consultation and treatment, assistant surgeons, anesthetist services, etc.
  3. Use of operating room, intensive care, cardiac care, drugs and medicines, inpatient and on discharge; injections, dressings, casts, blood transfusions, x-rays and isotope therapy, inhalation therapy, emergency care, short-term physical therapy and other therapeutic services.
 
Prescription Drugs and Durable Medical Equipment:
 
  1. Drugs prescribed by a primary care physician or a County Medical Case Management consultant to whom a patient has been referred provided at the county pharmacy in accordance with Sacramento County Drug Formulary Policy, and within the scope of appropriate Sacramento County Formularies.
  2. Durable medical equipment, prosthetic devices and medical supplies, subject to authorization
 
Ambulance Service:
Non-emergency ambulance service upon prior authorization of Sacramento County Medical Case Management.
 

Home Care:
In-home medical care services are provided when medically appropriate and are subject to utilization controls.


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