Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES › Chapter 11 - INDIAN HEALTH SERVICE (IHS) FACILITIES › Section 471-11-002 - PROVIDER REQUIREMENTS

Current through June 17, 2024
All regulations in the Title 471 NAC apply, unless stated differently
	 in this chapter.
002.01 General
  Provider Requirements
To participate in the Nebraska Medical Assistance Program (Medicaid),
	 IHS facilities shall comply with all applicable participation requirements
	 codified in 471 NAC Chapters 2 and 3. In the event that provider participation
	 requirements in 471 NAC Chapters 2 or 3 conflict with requirements outlined in
	 this 471 NAC Chapter 11, the individual provider participation requirements in
	 471 NAC Chapter 11 shall govern.
002.02 General Provider Requirements
To participate in the Nebraska Medical Assistance Program (Medicaid),
	 IHS facilities shall comply with all applicable participation requirements
	 codified in 471 NAC Chapters 2 and 3. In the event that provider participation
	 requirements in 471 NAC Chapters 2 or 3 conflict with requirements outlined in
	 this 471 NAC Chapter 11, the individual provider participation requirements in
	 471 NAC Chapter 11 shall govern. Service Specific Provider Requirements:
	 Medicaid accepts IHS facilities as Medicaid providers on the same basis as
	 other qualified providers. The facilities shall meet all applicable standards
	 for licensure by the Nebraska Department of Health and Human Services, Division
	 of Public Health (Licensure Unit), but need not be licensed. The absence of
	 Nebraska licensure of any staff member of an IHS facility may not be regarded
	 as failure to meet the standards for licensure of the facility, so long as that
	 member is licensed in another state. The Department verifies the Indian Health
	 Service facility status by contacting the appropriate Indian Health Service
	 area office.
11-002.02A Provider
  Agreement: An Indian Health Service facility shall submit to the Department
  (Medicaid) Form MC-19, "Medical Assistance Provider Agreement," (See
  471-000-91) and Form CMS-1539, "Medicare/Medicaid Certification and
  Transmittal," (see 471-000-66). Medicaid must approve enrollment before making
  payment to the IHS facility. A non-hospital-based provider who has met the
  Nebraska Department of Health and Human Services Regulation and Licensure
  standards shall submit to the Department Form MC-19, "Medical Assistance
  Provider Agreement," (see 471-000-90). Medicaid must approve enrollment before
  making payment to the provider.
11-002.02B Compliance with Provider
  Requirements: In addition to the limitations and requirements outlined in this
  471 NAC Chapter 11, IHS Providers shall comply with all applicable limitations
  in 471 NAC Chapters 1, 2 and 3, and all requirements outlined in each
  applicable service specific chapter in Title 471 of the Nebraska Administrative
  Code. As an example, IHS Providers of Dental Services must comply with both
  provider and service delivery limitations and requirements outlined in 471 NAC
  Chapter 6. IHS Providers of Pharmacy Services must comply with both provider
  and service delivery limitations and requirements in 471 NAC Chapter 16. These
  requirements apply to all services provided by IHS providers under the
  provisions of this 471 NAC Chapter 11.