ࡱ> y~x_ 1bjbjCC .j)D\)D\)"""""6666tt6WL^||||Wd[4KKKKKKK$qN'Q,K"WWK""||L****"|"|K*K**6?(xE|0+t :CK'L0WLD`SR SR8xExESR"2F*KK%WLSR> : Home Infusion Therapy HYPERLINK "javascript:link('dhs16_137531','hit03_02_16')"Revised: 03-02-2016 Overview Home Infusion Therapy Services offer an alternative to the hospital setting by making it possible for MHCP recipients to receive infusion therapy in the comfort of their own home. MHCP will cover home infusion therapy (HIT)-related services for eligible recipients when medically necessary and provided by an MHCP enrolled HIT pharmacy. Eligible Providers MHCP enrolled pharmacies that provide home infusion services must complete and submit the HYPERLINK "https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5947-ENG" \t "_blank"Home Infusion Pharmacy Applicant Assurance Statement (DHS-5947) (PDF) to be recognized as an HIT pharmacy. An HIT pharmacy may be in conjunction with a hospital pharmacy, long-term care pharmacy, or a community or retail pharmacy that prepares compounds and dispenses parenteral or enteral drugs for non-hospitalized patients and provides pharmaceutical care services. Eligible Pharmacies Eligible pharmacies must meet the following: Have or are applying for a designated parenteral-enteral or home health care license category with the Minnesota Board of Pharmacy. If located outside of Minnesota, an eligible pharmacy has Home Infusion Pharmacy designation with the state Medicaid office, if the state makes such designations. Have the ability to provide a full range of services, including but not limited to: Providing standards for preparation, labeling and distribution of sterile products by licensed parenteral-enteral or home care pharmacies Having a policy and procedure manual addressing sterile preparation of products, clinical services, drug disposal, drug dispensing, labeling, quality assurance, etc. Meeting physical space and equipment requirements Having 24-hour staffing (pharmacist on call) Shipping Handling of cytotoxic agents Having a process for systematic drug use review Monitoring patients Have the ability to provide administrative and professional pharmacy services, care coordination and all necessary supplies and equipment as defined by applicable home infusion HCPCS codes. Eligible Recipients Recipients eligible to receive HIT pharmacy services must be eligible for one of the following programs: BBMinnesotaCare Plus OneEHEmergency (only if part of an approved certified care plan)FFMinnesotaCare Basic Plus MinnesotaCare Basic Plus TwoJJMinnesotaCare Basic Plus MinnesotaCare Basic Plus TwoKKMinnesotaCare ExpandedLLMinnesotaCare ExpandedMAMedical AssistanceNMState-funded Medical AssistanceRMRefugee Ineligible Recipients Recipients not eligible for home infusion pharmacy services are those eligible for one of the following programs: ACAlternative Care ProgramFPMFPP (limited coverage)HHHIV/AIDS (limited coverage see HYPERLINK "http://mn.gov/dhs/people-we-serve/people-with-disabilities/health-care/hiv-aids/programs-services/drug-formulary.jsp" \t "_blank"ADAP Formulary)IMInstitution for Mental Disease People eligible for programs IM and HH may have limited coverage. Contact the MHCP Provider Call center at 651-431-2700 or 800-366-5411 to confirm benefit coverage for these MHCP programs. Recipients eligible for both MHCP and Medicare Part B and Part D (dual eligible) must select a Medicare Part D plan and receive most of their medication through their selected plan. MHCP covers only drugs excluded by law from Medicare Part D coverage. Providers must submit home infusion drugs and supplies eligible for Medicare Part B coverage to the Medicare Part B carrier. Do not bill MHCP for per diem codes for individuals who are dually eligible for Medicare. Covered Services HIT per diem (codes: S5497S5523, S9061, S9325S9331, S9336S9379, S9490S9504, S9537S9590) These codes include the following services: Initial patient assessment Professional pharmacy services Infusion therapy related equipment and supplies Teaching Coordination of care Delivery and removal of equipment and supplies HIT per diem codes S9364S9368 are used for Total Parenteral Nutrition (TPN). Pricing for the codes includes the services listed about and the cost of the standard TPN formula ingredients. Total Parenteral Nutrition Billing (TPN) Included in the TPN per diem Standard Products included in the TPN per diem codes (S9364S9368) are the following: Non-specialty amino acids (for example, Aminosyn, FreAmine, Travasol ) Concentrated dextrose (for example, D10, D20, D50, D60, D70) Sterile water Electrolytes (for example, CaCl2, KCl, KPO4, MgSO4, NaAc, NaCl, NaPO4) Standard multi-trace element solutions (for example, MTE4, MVE5, MVE7) Standard multivitamin solutions (for example, MVI-12 or MVI-13) Not included in the TPN per diem Additional ingredients not included in the TPN per diem are the following: Specialty amino acids for renal failure (for example, Aminess, Aminosyn-RF, NephroAmine, RenAmin) Specialty amino acids for hepatic failure (for example, HepatAmine) Specialty amino acids for high stress conditions (for example, Aminosyn-HBC, BrachAmin, FreAmine HBC, Premasol, TrophAmine) Specialty amino acids with concentrations of 15% and above when medically necessary for fluid restricted patients (for example, aminosyn 15%, Clinisol 15, Novamine 15%, Prosol 20%) Lipids (for example, Intralipid, Liposyn). Added trace elements not from a standard multi-trace element solution (for example, chromium, copper, iodine, manganese, selenium. zinc) Added vitamins not from a standard multivitamin solution (for example, folic acid, vitamin C, vitamin K) Products serving non-nutritional purposes (for example, heparin, insulin, iron dextran, Pepcid, Sandostatin, Zofran) Use the appropriate TPN HCPCS code(s) for additional ingredients that are not included in the standard TPN formula Lipids are currently covered under B4185. Nursing Visits (99601 and 99602) Home infusion and specialty drug administration must be performed by a skilled infusion nurse with specialized education and training in the alternate-site administration of drugs and biologics through infusion. Nursing Service may be billed by one of the following: Home Infusion Pharmacy that has employed a home infusion nurse for HIT nursing services Medicare Certified Home Health Agency Billing Submit HIT claims to all other payers, including Medicare Part B or Part D and private insurance companies, using their specific billing guidelines before submitting claims to MHCP. Pharmacies recognized as HIT pharmacies may bill for home infusion services. Pharmacies may bill for nursing visits related to the HIT services on the same claim if the nurse is employed by that pharmacy. Medicare-certified home health agencies may bill for nursing visits for HIT services performed by a nurse employed by that agency. Fee-for-Service (MHCP coverage only) If the recipient has no other third party coverage Submit the claim to MHCP using the 837P (Professional) claims transaction by following these steps: Enter the date span for the number of days the drugs and supplies were dispensed. Enter the appropriate HCPCS code for the drug or TPN ingredient not included in the TPN per diem. Enter the quantity dispensed. Enter the NDC code and quantity associated with the drug HCPCS code entered on the claim. (This information is reported in the LIN and CTP segments on a batch claim or in the Drug Pricing section on the Services screen in MNITS.) If the dose under the procedure code requires the use of two different vial sizes, then use the following modifiers for the two NDCs: KP modifier for the first vial size KQ modifier for second vial size On the next line of the claim, enter the appropriate HIT HCPCS code (per diem S codes) and the appropriate modifier when applicable. Effective Jan. 1, 2015, using SH and SJ modifiers will reduce line item payable to 50 percent of the current allowable charge): SH 2nd Therapy Second concurrently administered infusion therapy SJ 3rd Therapy Third or more concurrently administered infusion therapy Coordination of Benefits (Other payers or coverage exists) Medicare When billing for dual eligible recipients (recipients eligible for both HYPERLINK "javascript:link('dhs16_140411','')"Medicare and MHCP), you must research or contact the Medicare Part B or Part D plan to determine which Medicare plan will pay the HIT drug or TPN billable ingredients. In most cases, MHCP will pay for the HIT supplies even if Medicare Part B or Part D denies coverage for the drug or TPN (additional ingredients not included in the TPN per diem) MHCP will pay only for the Medicare Part B coinsurance or deductibles up to the MHCP allowable rate for HIT covered drugs, TPN billable ingredient and HIT supplies. For HIT supplies, bill Medicare Part B using the appropriate HCPCS codes recognized by Medicare as home infusion supplies. (A codes) MHCP does not pay for home infusion drugs or TPN ingredients not covered by Medicare Part B or Part D MHCP does not pay for Part D copays Do not bill MHCP using per diem HIT codes if the recipient has Medicare eligibility Medicare Part B If the Part B plan will cover the HIT drug or TPN billable ingredients, bill the Part B plan following the Part B plans billing and coding requirements on the 837 (Professional) claims transaction. Enter the NDC and the quantity dispensed so that the information crosses over to MHCP for payment. Without the NDC and quantity the Medicare crossover claim will deny and have to be resubmitted to MHCP for payment. Medicare Part D If the Part D plan will cover the HIT drug or TPN ingredients follow the Part D plans billing and coding requirements. Follow these requirements: For drugs covered by Medicare Part D, use the Pharmacy NCPDP D.0 claims transaction for the Part D drugs Use the appropriate NDC code and the quantity dispensed Bill Medicare Part B on a separate claim for the HIT supplies using the 837P (Professional) claims transaction Private Insurance (TPL) When TPL coverage is available, submit the claim to the other payer following the coding and billing requirements of that payer. If the TPL requires billing and coding different from MHCP, after the claim has been adjudicated by the TPL submit the claim to MHCP following MHCP FFS HIT billing and coding requirements and include payment and adjustment codes as reported on the TPL EOB. Keep documentation on file explaining the different billing and coding requirements. Additional Resources/References HYPERLINK "https://www.revisor.mn.gov/statutes/?id=256B.0625" \t "_blank"Minnesota Statutes, Section 256B.0625 Sub. 8d  PQRY\]^`defgqv # % & + 0 5 6 7 ; < D E Q R b p z {  yr hh8u h[h8u hhIh-Zh~ h"hI h[hI hhKs h[hKsh3t7h+ hh+ hh4h+h hZx0JhPhP0J h0JjhZxUhZxjhPUh4MhI hd$h4M,ghq% &  ; b @  h^gdPgdPgdY3gd$psgdtfbgdY & Fgd47 & Fh^h`gdlgd+gdtfbgdPgdC    0 1 2  1 s {  : ÿÿÿÿxthsk h3=hY hwhh4h!}hhJh!hAwh&hh-Z h$ps0Jjh$psUh$psjh47Uh47 hPh47hY hPhA hPhwhl h"hIh3t7 h[hI h[hg hhI*: ; = ? @ C F G s w b f g '+P]MNmnow  1:DEFGJbcʿʸʴʬhtfbh hj45hj4 h^5hj4h 9hj45hhAhwh4MhUh3= hPhC h! hPhHn hPh4M hPhghE hlhghg hlh4MhY hlhY h3=hsk2@EOlno $IfgdcHKgdTgdtfb & Fgdh4gdY3^gdP  FGJ2bkdc$$Ifs0 t644 sapyt$ps $IfgdcHKbkd$$Ifs0 t644 sapyt$psJ2bkd=$$Ifs0 t644 sapyt$psbkd$$Ifs0 t644 sapyt$ps $IfgdcHK +,/79OZ]gky񽹽ɪhh4h D^Jhh4hE^J hE^JhAhj40JhZxjhj4Uhh hKh 0J" hKh  htfbhjh 9hj45 hj45hj4 h^5hj4htfb;bkd$$Ifs0 t644 sapyt$ps $IfgdcHK 2bkd$$Ifs0 t644 sapyt$ps $IfgdcHKbkd$$Ifs0 t644 sapyt$ps +,/782bkd^$$Ifs0 t644 sapyt$psbkd$$Ifs0 t644 sapyt$ps $IfgdcHK89Obkd$$Ifs0t t644 sapyt$ps $IfgdcHKgdtfbgdh42bkd$$Ifs0t t644 sapyt$ps $IfgdcHKbkd8$$Ifs0t t644 sapyt$psst*{vn hgdh4gdIdlgdZxgdtfbgdh4gdkgdtfbbkd$$Ifs0t t644 sapyt$ps $Ifgdj4 "JPqrt Ľzvrnjfbfj[T hPhp hTh hskhIdlh hkhyhhZxh@'0J"hZxh-Z0J"hZxhIdl0J"hZxhy0J"hZxh0J"hZxhq0J"hZxh 0J"h}` hh4h D hh4hhhhCJOJQJaJhh4h^Jhh4h-Z^Jhh4h D^J hj^J *Iy"lEX  hgdh4gd=3  hgdh4gdh4gdcgdh4gdtfb hgdh4$23^j "=HRS]ιέ}vrnrjfbf]f hZbH*hEhZbhskh kh[ hh/e hh4 hhZb hjhZbhh4hh4hj0J" hchnU hchZbhh4hht0J"5\ hh4h9' hh4h" hh4h hh4h[ hh4h-Zhh4h-Z5 hr|5hh4h[5 hh4hLh9'hnU$]^_`hj&1fr&/0=>KLUV żhh4hZb0J hsk0Jh=3hZb0Jh=3h-Z0Jh=3h750Jh=3h0Jh=3hh40J5h=3hj0J5 h=3hZbh*hEhZb h9'H*hh4h9'0J hZbH*901LW#.VWdegmnoq  056=BCLMQR  & : < Źhsk0J"5\hh0J"\hhth0J"5\hl40J"5\hmmh0J"5\ hchhh4h[hhBxh/eh h75h75h75hFDhE hZbH*hZb9pq0  < y!z!G"H""""##<$gd9'gdtfbgdtfbgdh4gdgdcgd75gdtfbgdh4< R !#!$!-!.!/!W!`!i!o!y!z!x"y"""""""##$#C#[#b#m########$$$ռ䩥{ h1jhThqG h1jhWhskhW hPhWha h5h%hhZ-D h/qhGhG hh4h@% h~h<h@%h-Z h3=h@%h@%h4M hd$h4Mhkhh4h ]0J"5\hh4h0J"5\.$$2$:$E$X$Y${$$$8%?%@%A%B%%%%%%%%%%&&1&g&h&l&&&&&&&&&&&&|xttpxlxhh4h'hFDhOPh>hZ-D hm\hm\hm\h h1jh {hoh {0J!hHh {0J!hf*h {0J! h'0J!h h 0J! h 0J! hsk0J! hl40J!h1jh$0J! h1jh$ h1jhWhsk h1jhTh"hqGh[(<$[$B%%%&'\''''))f**Q+u+++,,gdOOgdgdqgdh4gdtfbgdtfb^gdI^gdh4  h^gdZxgdf*gd gdh4&'''')'*'b'd'''''''''''''((!("(5(6(d(e(f(n(o(x(y({(~((((((((((((((())Ƚ̢蕵ĵĉhR?xhw?hh ]hzhhB|h@%0JjhOOUjhB|Uhh@% hU;h@%hl4hhOOhh4h@5hGhShhm\h4hPhIH*hIh'h>3)))))))***$*<*@*S*e*f**+'+1+4+P+Q+V+t+u++++++++, ,#,R,S,,,,,,Ľ{{wplhu, hh4hskh1h5vh3h[ hh4h1hOOhh4h)c5hh4hq5hGhFDhhwYh'S h~h<hwY h[hG h[h'S hh'Sh6RhqhR?xh]B%h@%hj hhjhS hhGhPTD*,,--1-;-z-{-|----------......//0/G/H/P/Q/Z/\/h/n//////////////000 0ƾƶѧ􄀄h>ahGhR?xhh'ShN h&h-Zh-Zh$T hh4h\hh4h\5h;hzhZ-Dhh1 h~h<h1hOOhh4h%5hhq5 hOOh{hSh{h3hh%2,-{-|-...//0/1 1@111111gdtfbgdPgdh4gdOOgdtfbgd$ps 050\0`00000000011 1?1@1A111111111111111111111Լԣtj@ hVh/<Uj% hVh/<UjM hVh/<UhQhOOhAhAhw0J h'0J h40JhAhA0JjNhcUhcjhAUhho h4Mh;hh>ah[hR?xhG%,1h/ =!h"h#$% DyK yK tjavascript:link('dhs16_137531','hit03_02_16')yX;H,]ą'cDyK _blankyK https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5947-ENGyX;H,]ą'ck$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psk$$If!vh#v#v:V s t654 spyt$psDyK yK ^javascript:link('dhs16_140411','')yX;H,]ą'cDyK _blankyK |https://www.revisor.mn.gov/statutes/?id=256B.0625yX;H,]ą'cDd\  C *Aicon_doc"@@b(Y T=f? 3nY T=f?PNG  IHDRRPLTEt?:bKGDHgIFg cmPPJCmp0712OmYIDAT% e00t"u{]N 7+`yLYkSCf8%,,~ M\*)CHp gFgEIENDB`Dd\  C *Aicon_pdf"@@bkC*2 @E@:Gi 3n?C*2 @E@:PNG  IHDRR0PLTEfff̙Y( tRNS="bKGDHgIFg cmPPJCmp0712OmkIDAT% 0 - P@ 1E  Ca'__Co Èh2ʘLg]yt*NϠp3zGH<35G/-IENDB`Dd\  C *Aicon_xls"@@b%P^GR)Z 3nP^GR)ZPNG  IHDRRPLTEƄ MbKGDHgIFg cmPPJCmp0712OmVIDAT% 0 CQ3IN$埬'VAXD&-`e,-*j\G*"[VCzxQHp%IENDB`%s2 0@P`p2  0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p0PV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ (UNormalOJQJ_H mH sH tH ZZ  Heading 1$<@&5CJ KH OJQJ\^JaJ r "r  Heading 2$<@&65B*CJOJQJ\]^J_HaJmH ph33sH tH NN C Heading 3$<@&5CJ\^JaJDA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List 6U`6 Gv Hyperlink >*B*phDD  idocscript5B*OJQJphfof  paraHeader65B*CJOJQJ\]^J_HaJmH ph$sH tH ^o"^  sectionHeader(5B*CJOJQJ_HmH ph33sH tH Jo2J  bodyContentOJQJ_HmH sH tH XoBX  pageHeader(5B*CJOJQJ_HmH ph33sH tH <0@R< 4M List Bullet  & Fm$jcj M%^ Table Grid7:V0HrH I Balloon TextCJOJQJ^JaJR/R IBalloon Text CharCJOJQJ^J_H aJPoP fbodyContent CharOJQJ_HmH sH tH XX 4M List Paragraph ^m$CJOJQJ_HaJB' B C Comment ReferenceCJaJ44 C Comment TextF/F C Comment Text Char OJQJ_H @j@ C Comment Subject5\R/R C Comment Subject Char5OJQJ\_H Z/Z %Heading 2 Char&5B*CJOJQJ\]^JaJph33 o $list*W`!*  Strong5\FV 1F 6TFollowedHyperlink >*B*phD BD!}0Revision$OJQJ_H mH sH tH PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] )j : ]< $&), 01 ')*+-.0124@J 8*<$,1!"#$%&(,/3Qe1 5 e n @))))XXXXX8@0(  B S  ? overvieweperircstpnnursingbillfeebenefits resources_PictureBulletsho9 t ))) qO 0@)))JRU]`h(/2:@KNU Yd)))Z^F'G')))333Q\]^`deQR2{{ :;;sw'+b c 8 8 9 9 O O  ] ]  =H&1fr&01LW#.ggijmmpp//%%&:VV#$mXY[[<<?@A)*{ ~ e"e"######{${$$$y%y%{%{%%%&&/'/'4(4(A)))))))))))Q\]^`deQR2{{ :;;sw'+b c 8 8 9 9 O O  ] ]  =H&1fr&01LW#.ggijmmpp//%%&:VV#$mXY[[<<?@A)*{ ~ e"e"######{${$$$y%y%{%{%%%&&/'/'4(4(A))))))))))) 2DLV1`Jp2v?= z2G *Nnw%jF<=nIƩsrZXP]x1 ^`OJQJo( hh^h`OJQJo(h h^h`OJQJo(h8^8`OJQJ^Jo(hHoh^`OJQJo(hHh ^ `OJQJo(hHh ^ `OJQJ^Jo(hHohx^x`OJQJo(hHhH^H`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh ^`OJQJo(h^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hH h^h`hH. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.^`.h^`CJOJQJo(hHpL^p`L.@ ^@ `.^`.L^`L.^`.^`.PL^P`L. ^`OJQJo(^`OJQJ^Jo(o pp^p`OJQJo( @ @ ^@ `OJQJo(^`OJQJ^Jo(o ^`OJQJo( ^`OJQJo(^`OJQJ^Jo(o PP^P`OJQJo(h h^h`OJQJo(8^8`.L^`L. ^ `. ^ `.xL^x`L.H^H`.^`.L^`L.^`.h^`OJQJo(hHpL^p`L.@ ^@ `.^`.L^`L.^`.^`.PL^P`L. ^`OJQJo(^`OJQJ^Jo(o pp^p`OJQJo( @ @ ^@ `OJQJo(^`OJQJ^Jo(o ^`OJQJo( ^`OJQJo(^`OJQJ^Jo(o PP^P`OJQJo(h h^h`hH.h 8^8`hH.h L^`LhH.h  ^ `hH.h  ^ `hH.h xL^x`LhH.h H^H`hH.h ^`hH.h L^`LhH.5srnw%<=P]x= I1`2vG                   X|         $                                           X|        yE$&Mx((wMx(yEY 2]j347Y 2W?=mi]j$& ^]wY%o+|4"9'iQ}lu,;/+Ttm@ L o w?   }` C E nQ ITYYU;LIbU1"! ;4n5qsyUl $E#O#$]B%Z%''@'kZ)g)f*-r-9 1z1h4$4W5573t7~78M^8 9K;5=g=$n=5>>7>S>6?G^@AfA| C8bC|C~CZ-DPTDzD2E"FoFqGIcHKyM4Matfb)c*c/c`c*d_gw?h i8j k-ksk9yklblIdl6moo/q =rs$psItGv$"wR?xBxcZxZxVyny !{|_|1h|!}<@%P$T&BK Ql4+?\W%ENJYx2yY3j4FD|R/|}*<ZbNkH[8u/e{/I\"!SS HlHpi47DC ,OP>Tn.'3qd!##QwC7j,t75 g! {DhtG1~WNZfc} 8+gYtP^amCu{AhJS DoC(U~x r|9t&;IB|!kb Y@=3o*Hn2$HKOOT@8LEz3=kf",I_~3 G ]kKs%G $pTnUl\e>|llc%N(pAw1j&a5v15w))@   )@Unknown G*Ax Times New Roman5Symbol3. *Cx Arial7@Cambria5. .[`)Tahoma7.@Calibri?= *Cx Courier New;WingdingsA$BCambria Math"1hCgCgzG;#K;#Kh4)) 2qKX 0 N25!xxj IX:\WebServices\Stellent User Group\Templates\PublicCountyLinkTemplate.dot"Home-Infusion-Therapy_dhs16_170195pwskh27Schreier, Sandy8         Oh+'0 (4 T ` l x$Home-Infusion-Therapy_dhs16_170195pwskh27PublicCountyLinkTemplateSchreier, Sandy3Microsoft Office Word@ @4g@$,t@RWordDocument.jSummaryInformation(hDocumentSummaryInformation8pMsoDataStore Pt0+tWKLWOVT0IVVA==2Pt0+tItem  PropertiesOWG5YSE1NZS2==2 Pt0+tItem  y'Properties @WBVBESTHB0Q==2Pt0+tItem Properties/A0HVPPTGCMUGOVA==2Pt0+tItem 5Properties7SCompObj=r  !"#$%&'()*+,-.01234689:;<>DocumentLibraryFormDocumentLibraryFormDocumentLibraryForm This value indicates the number of saves or revisions. The application is responsible for updating this value after each revision. metaAttributes"/>Nintex conditional workflow startSynchronous1000150000Nintex.Workflow, Version=1.0.0.0, Culture=neutral, PublicKeyToken=913f6bae0ca5ae12Nintex.Workflow.ConditionalWorkflowStartReceiver10/9/2013 7:52:38 PMNintex conditional workflow startSynchronous1000250000Nintex.Workflow, Version=1.0.0.0, Culture=neutral, PublicKeyToken=913f6bae0ca5ae12Nintex.Workflow.ConditionalWorkflowStartReceiver10/9/2013 7:52:38 PMNintex conditional workflow startSynchronous250000Nintex.Workflow, Version=1.0.0.0, Culture=neutral, PublicKeyToken=913f6bae0ca5ae12Nintex.Workflow.ConditionalWorkflowStartReceiver10/9/2013 7:52:38 PM   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q