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:

S. GENERAL MEDICINE/ LABORATORY - NOT COVERED

Biopsies, unless clinically indicated and preauthorized by the Office of Interagency Medical Services

Blood typing for paternity testing

Blood cholesterol test, urinalysis, complete blood count (CBC), and blood chemistry tests, unless clinically indicated or the detainee has been in the uninterrupted custody of the USMS for greater than 12 months

Screening endoscopies, unless clinically indicated and preauthorized
by the Office of Interagency Medical Services

Machine Diagnostic Tests (eg PET, MRI, echocardiogram, CT scan)unless ordered by a physician or mid-level provider with clinical findings indicating medical necessity

Physical examinations not necessary for medical reasons

PSA (Prostate Specific Antigen), unless clinically indicated or the detainee has been in the uninterrupted custody of the USMS for greater than 12 months and is over the age of 50 years.

Semen fructose test

Semen analysis

Sperm antibodies

Sperm evaluation

Splitting of blood or blood products

Tissue hybridization