DHS 107.122(2)(b)(b) Requests for prior authorization shall be accompanied by the written protocol. DHS 107.122(3)(a)(a) No services under this section may be reimbursed without a written protocol developed and signed by the nurse practitioner and the delegating physician, except for general nursing procedures described under s. N 6.03 (1). The physician shall review a protocol according to the requirements of s. 448.03 (2) (e), Stats., and guidelines established by the medical examining board and the board of nursing, but no less than once each calendar year. A written protocol shall be organized as follows: DHS 107.122(3)(b)(b) Prescriptions for drugs are limited to those drugs allowed under protocol for prescription by a nurse practitioner, except that controlled substances may not be prescribed by a nurse practitioner. DHS 107.122(4)(b)(b) Services provided to nursing home residents or hospital inpatients which are included in the daily rates for a nursing home or hospital; DHS 107.122(4)(e)(e) Medical acts for which the nurse practitioner or clinical nurse specialist does not have written protocols as specified in this section. In this paragraph, “medical acts” means acts reserved by professional training and licensure to physicians, dentists and podiatrists. DHS 107.122 HistoryHistory: Emerg. cr. eff. 7-1-90; cr. Register, January, 1991, No. 421, eff. 2-1-91; correction in (1) (e) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 1999, No. 520. DHS 107.13(1)(a)(a) Covered services. Inpatient hospital mental health and AODA care shall be covered when prescribed by a physician and when provided within a hospital institution for mental disease (IMD) which is certified under ss. DHS 105.07 and 105.21, except as provided in par. (b). DHS 107.13(1)(b)(b) Conditions for coverage of recipients under 21 years of age. DHS 107.13(1)(b)1.1. ‘Definition.’ In this paragraph, “individual plan of care”or “plan of care” means a written plan developed for each recipient under 21 years of age who receives inpatient hospital mental health or AODA care in a hospital IMD for the purpose of improving the recipient’s condition to the extent that inpatient care is no longer necessary. DHS 107.13(1)(b)2.2. ‘General conditions.’ Inpatient hospital mental health and AODA services provided in a hospital IMD for recipients under age 21 shall be provided under the direction of a physician and, if the recipient was receiving the services immediately before reaching age 21, coverage shall extend to the earlier of the following: DHS 107.13(1)(b)3.a.a. For recipients under age 21 receiving services in a hospital IMD, a team specified in subd. 3. b. shall certify that ambulatory care resources do not meet the treatment needs of the recipient, proper treatment of the recipient’s psychiatric condition requires services on an inpatient basis under the direction of a physician, and the services can reasonably be expected to improve the recipient’s condition or prevent further regression so that the services will be needed in reduced amount or intensity or no longer be needed. The certification specified in this subdivision satisfies the requirement for physician certification in subd. 7. In this subparagraph, “ambulatory care resources” means any covered service except hospital inpatient care or care of a resident in a nursing home.