Katie Beckett Program Medical Necessity Form

This document is a guide for completing the Medical Necessity and Level of Care form for the Katie Beckett Program (KBP), which is designed for children with long-term disabilities or complex medical needs. It outlines the necessary steps for parents and physicians to ensure that the Medicaid application packet is completed accurately. The form requires detailed beneficiary information, including the child's medical history, current medications, and any hospitalizations. It specifies the documentation needed to support the application, such as physician orders and therapy notes. The document also describes the three institutional levels of care: Hospital, Nursing Facility, and Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). Each level has specific eligibility criteria and documentation requirements that must be met to qualify for KBP benefits. The guide emphasizes the importance of accurate medical documentation and provides instructions for physicians to recommend the appropriate level of care based on the child's current condition.