All correspondence must be made through the Vendor Portal. Specifications include, but are not limited to: i. Outpatient Ambulatory Services: Provision of professional diagnostic and therapeutic services, consistent with the most current published U.S. Department of Health and Human Services treatment guidelines, to a client by a licensed healthcare provider in an outpatient medical setting. Outpatient medical settings include clinics, medical offices, and mobile vans where clients do not stay overnight. Emergency room services are not considered outpatient settings. Key activities include medical history taking; physical examination; diagnostic testing, including laboratory testing (see separate definition below); treatment and management of physical and behavioral health conditions; behavioral risk assessment, subsequent counseling, and referral; preventive care and screening; prescription and management of medication therapy; treatment adherence; education and counseling on health and prevention issues; and referral to and provision of specialty care related to HIV diagnosis. ii. Diagnostic Laboratory Testing Services: Includes all indicated medical diagnostic testing, including all tests considered integral to the treatment of HIV and related complications, e.g. viral load, CD4 counts and genotype assays. Funded tests must meet the following conditions: • Tests must be consistent with medical and laboratory standards as established by scientific evidence and supported by professionals, panels, associations, or organizations; • Tests must be (1) approved by the FDA, when required under the FDA Medical Devices Act and/or (2) performed in an approved Clinical Laboratory Improvement Amendments of 1988 (CLIA) certified laboratory or State exempt laboratory; and • Tests must be (1) ordered by a registered, certified or licensed medical provider and (2) necessary and appropriate based on established clinical practice standards and professional clinical judgment. For Diagnostic Laboratory Testing Services, funded service providers are required to: Provide or assure the provision of laboratory related diagnostic services. The funded service provider may contract directly with a laboratory of their choosing and may pay for these services, then charge the CITY. This is commonly called “pass through billing.” If the funded service provider chooses this option, they must submit monthly roster billing based upon mutually agreed laboratory charges. Any deviation must be approved by Columbus Public Health. Primary medical care for the treatment of HIV infection includes the provision of care that is consistent with the Public Health Service’s guidelines. Such care must include access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies.
