MHCP Medical Need (DHS-6112)
After the Medical Care Received (DHS-6059A) or the DHS-3543 Request for Payment of Long-Term Care Services form is returned and the verification provided, you must review each expense listed by the client to be sure that each condition is met. One of those conditions is that the expense must be medically necessary. You must verify medical necessity of expenses not provided by a provider, such as a medical professional, ambulance service, pharmacy, or medical facility.
The MHCP Medical Need form (DHS-6112) (PDF) (titled ‘Medical Need’ on the front side) was created to help you verify medical necessity. The DHS-6112 provides a release of information for the client to sign to allow one provider to communicate with you. It is not a required form.
The client can either:
- Sign the release and give the form directly to the physician to complete and return to the county.
- Return it to you. You must then send it to the physician to complete and return.
If the client or the physician does not return the form within the processing period, do not allow the expense to be used as a deduction.
To Do: Take a minute to review the DHS-6112 and note the sections you must complete before sending.
Page 4
The MA-LTC Medical Expense Deduction - Forms