Prisoner Health Care Standards

I. Reasonable and Medically Necessary Care

II. Conditions Requiring Treatment

III.  Non-authorized Medical Interventions/ Procedures

IV. Appeals/Denials Process

The following medical interventions and procedures are not authorized for payment by the USMS, unless ordered by the court:

B. CARDIOLOGY - NOT COVERED

Ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring, physician review

Ambulatory blood pressure monitoring, scanning analysis

Ambulatory blood pressure monitoring, recording

Cardiac rehabilitation, unless ordered in writing by a physician or mid-level provider after a cardiac incident or surgery and preauthorized by the Office of Interagency Medical Services

Donor cardiectomy-pneumonectomy

Donor cardiectomy

Electrocardiograms, unless ordered by a physician or mid-level provider based on clinical findings suggestive of cardiac disease

Heart transplant

Heart-lung transplant

Photopheresis, extracorporeal

Plethysmography

Prolonged extracorporeal circulation for cardiopulmonary insufficiency

Single or multiple injections of sclerosing solutions