Library: Policy

317:30-5-336.2. Nearest appropriate facility

Issued 12-21-06

(a) OHCA covers transportation to the nearest facility that can appropriately treat the member.

(b) An institution is not considered an appropriate facility if the member's condition requires a higher level of care or specialized services available at the more distant hospital.  However, a legal impediment barring a member's admission would mean that the institution did not have "appropriate facilities".  For example, the nearest transplant center may be in another state and that state's law precludes admission of nonresidents.

(c) An institution is not considered an appropriate facility if no bed is available. However, the medical records must be properly documented.