Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.06-069 - Child Health Services / Early Periodic Screening, Diagnosis and Treatment (EPSDT) Update Transmittal #80

Current through Register Vol. 49, No. 6, June, 2024
Section
			 II
Child Health Services/Early and Periodic
			 Screening, Diagnosis, and Treatment
202.000
Arkansas Medicaid Participation
			 Requirements for School-Based Child Health Services Providers
School districts and education service cooperatives may provide
				all Child Health Services (CHS/EPSDT) screening services. A school district or
				cooperative may participate at one of two levels, as either a comprehensive
				screening provider who will provide all EPSDT screening components, or as a
				provider for vision and/or hearing screens.
Schools enrolling as comprehensive screening providers must
				meet the following criteria:
A. The
			 provider must complete a provider application (form DMS-652), a Medicaid
			 contract (form DMS-653) and a Request for Taxpayer Identification Number and
			 Certification (Form W-9).
View or print a provider
			 application (form DMS-652), a Medicaid contract (form DMS-653) and a Request
			 for Taxpayer Identification Number and Certification (Form
			 W-9).
B. The
			 provider application and Medicaid contract must be approved by the Arkansas
			 Medicaid Program.
C. The Arkansas
			 Medicaid Program must approve the provider application and the Medicaid
			 contract as a condition of participation in the Medicaid Program. Persons and
			 entities that are excluded or debarred under any state or federal law,
			 regulation or rule are not eligible to enroll, or to remain enrolled, as
			 Medicaid providers.
D. The provider
			 must sign an agreement to participate as a Child Health Services (CHS)
			 screening provider.
View or print participating EPSDT
			 provider agreement.
E. The provider must be certified as a
			 comprehensive CHS/EPSDT provider by the superintendent of schools.
View or print Certification of Schools to Provide
			 Comprehensive EPSDT Services form.
Schools or education service cooperatives enrolling as
				screeners for hearing and vision, hearing only or vision only must meet the
				following criteria:
A. The
			 provider must complete a provider application (form DMS-652), a Medicaid
			 contract (form DMS-653) and a Request for Taxpayer Identification Number and
			 Certification (Form W-9).
View or print a provider application
			 (form DMS-652), a Medicaid contract (form DMS-653) and a Request for Taxpayer
			 Identification Number and Certification (Form W-9).
B. The provider application and Medicaid
			 contract must be approved by the Arkansas Medicaid Program.
C. The Arkansas Medicaid Program must approve
			 the provider application and the Medicaid contract as a condition of
			 participation in the Medicaid Program. Persons and entities that are excluded
			 or debarred under any state or federal law, regulation or rule are not eligible
			 to enroll, or to remain enrolled, as Medicaid providers.
D. The provider must sign an agreement to
			 participate as a CHS screening provider per Section
			 201.000 of this manual.
View or print participating EPSDT provider
			 agreement.
E. The
			 provider must employ a licensed registered nurse or licensed practical nurse
			 who has completed training in vision screening conducted by the Arkansas
			 Department of Education, in conjunction with the Arkansas Eye and Vision
Commission. The RN or LPN must also have completed training in
				hearing screening conducted by the regional Educational Service Cooperative's
				Community Health Nurse Specialist. A copy of the nurse's current license and
				the certificate of completion of vision and hearing screening training must
				accompany the application. All vision and hearing screenings must be performed
				in accordance with the Arkansas State Board of Nursing School Nurse Practice
				Guidelines.
NOTE: School districts or education service cooperatives
				employing a qualified speech pathologist may complete an agreement to
				participate as a screening provider, using the speech pathology Medicaid
				provider number. The qualified speech pathologist may perform hearing screens
				and be reimbursed under the Medicaid provider number for speech
				pathology.
In situations where speech pathology services are provided by a
				qualified speech pathologist who is contracted with a school district or an
				education service cooperative, the individual qualified speech pathologist may
				complete the agreement to participate as a CHS screening provider and perform
				hearing screens under the individual Medicaid
				number.