BOIS FORTE CONTRACT HEALTH PRIORITIES

 

              Fund availability and rising costs have combined to limit the services available under the Bois Forte Contract Health Services (CHS) Program.

 

 

A.          CHS will cover the following services if the patient is referred for the procedure by a Bois Forte Clinic Health Care Provider:

 

              (1)          Mammograms

 

              (2)          Prostate-specific Antigen (PSA) Tests

 

              (3)          Colorectal Cancer Screening/Colonoscopy

 

              (4)          Cardiac Rehabilitation

 

B.           CHS will cover the following emergency care services:

 

(1)          To treat the sudden unexpected onset of illness or injury which, if left untreated or unattended until the next available clinic hours, would result in hospitalization, or

 

(2)          To treat a condition requiring professional health services immediately necessary to preserve life or stabilize health.

 

C.          CHS referral procedures (except in emergencies, as set out in B, above)

 

              All persons residing within the Contract Health Service Delivery Area (CHSDA) must first see a Bois Forte Medical Clinic Health Care Provider.  CHS eligibles must seek and make an appointment at a Bois Forte Clinic before CHS will refer to an outside provider.

 

D.          CHS Prescription Coverage:

 

(1)          CHS requires CHS-eligible patients to use the Bois Forte Clinic Pharmacy as the primary provider.

 

(2)          Existing prescriptions written by health care providers other than those at Bois Forte must be transferred to the Bois Forte Pharmacy to be covered by CHS.

 

(3)          Prescriptions must be called into the Bois Forte Pharmacy at least 24 hours in advance to be filled/refilled.

 

(4)          CHS will cover only generic drugs unless a generic version is not available or a Bois Forte provider expressly directs use of a non-generic drug.

 

(5)          CHS will cover narcotics not on the Bois Forte Pharmacy formulary only if the patient submits a written, notarized designation of the pharmacy at which their narcotic prescription will be filled.

 

Approved:  October 28, 2010.

 

Effective date:  December 1, 2010.