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37.79.303    BENEFITS NOT COVERED

(1) In addition to any exclusions noted elsewhere in these rules, the following services are not covered benefits:

(a) experimental services or services generally regarded by the medical profession as unacceptable treatment;

(b) custodial care;

(c) personal comfort, hygiene, and convenience items which are not primarily medical in nature;

(d) whirlpools;

(e) organ and tissue transplants;

(f) treatment for obesity;

(g) acupuncture;

(h) biofeedback and neurofeedback;

(i) chiropractic services;

(j) cosmetic surgery;

(k) radial keratotomy;

(l) private duty nursing;

(m) treatment for which other coverage such as workers' compensation is responsible;

(n) routine foot care;

(o) any medical transportation;

(p) ambulance services;

(q) abortions which are not performed to save the life of the mother or to terminate a pregnancy which is the result of an act of rape or incest;

(r) in vitro fertilization, gamete or zygote intra fallopian transfer, artificial insemination, reversal of voluntary sterilization, transsexual surgery, or fertility enhancing treatment beyond diagnosis;

(s) acupressure;

(t) contraceptives, for the purpose of birth control;

(u) temporomandibular joint (TMJ) treatment;

(v) hypnosis;

(w) cochlear implants and associated components;

(x) durable medical equipment; and

(y) any treatment which is not medically necessary.

 

History: 53-4-1004, 53-4-1009, 53-4-1105, MCA; IMP, 53-4-1003, 53-4-1004, 53-4-1009, 53-4-1104, 53-4-1105, MCA; NEW, 2000 MAR p. 1221, Eff. 5/12/00; AMD, 2004 MAR p. 330, Eff. 2/13/04; AMD, 2008 MAR p. 49, Eff. 1/18/08; AMD, 2009 MAR p. 1673, Eff. 10/1/09; AMD, 2010 MAR p. 1539, Eff. 7/1/10.

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