Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 9 - Children's Choice Waiver › Chapter 115 - Provider Participation Requirements › Subchapter B - Provider Requirements › Section XXI-11523 - Enrollment

Current through Register Vol. 50, No. 6, June 20, 2024
A. Both support
					 coordination and direct services providers must comply with the requirements of
					 this §11523 in order to
					 participate as Children Choice providers. Agencies will not be added to the
					 Freedom of Choice (FOC) list of available providers maintained by OCDD until
					 they have received a Medicaid provider number.
B. Providers shall attend all mandated
					 meetings and training sessions as directed by OCDD as a condition of enrollment
					 and continued participation as waiver providers. Attendance at a provider
					 enrollment orientation shall be required prior to enrollment as a Medicaid
					 provider of services. The frequency of the provider enrollment orientations
					 shall be determined by LDH Health Standards Section.
C. A separate provider enrollment packet must
					 be completed for each site in each LDH administrative region where the agency
					 will provide services.
D.
					 Participant case records and billing records shall be housed at the site in LDH
					 administrative region where the participant resides.
E. Providers may not refuse to serve any
					 waiver participant that chooses their agency to provide services.
F. Providers shall have available computer
					 equipment and software necessary to participate in prior authorization and data
					 collection as described in the Children's Choice Provider Manual.
G. Providers shall participate in initial
					 training for prior authorization and data collection. This initial training and
					 any LDH scheduled subsequent training addressing program changes is to be
					 provided at no cost to the agency. Repeat training must be paid for by the
					 requesting agency.
H. Providers
					 shall develop a quality improvement plan which must be submitted for approval
					 within 60 days after LDH training. Self-assessments are due six months after
					 approval of the plan and yearly thereafter.
I. The agency must not have been terminated
					 or actively sanctioned by Medicaid, Medicare or other health-related programs
					 in Louisiana or any other state.
J.
					 The agency must not have an outstanding Medicaid program audit exception or
					 other unresolved financial liability owed to the state.
K. Providers shall be certified for a period
					 of one year. Re-certification must be completed no less than 60 days prior to
					 the expiration of the certification period.
L. Waiver services are to be provided only to
					 persons who are waiver participants, and strictly in accordance with the
					 provisions of the approved plan of care.
M. Changes in the following areas are to be
					 reported to both OCDD and the Provider Enrollment Section in writing at least
					 10 days prior to any change:
1.
					 ownership;
2. physical
					 location;
3. mailing
					 address;
4. telephone number;
					 and
5. account information
					 affecting electronic funds transfer.