Section 29-4611. REIMBURSEMENT

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4611.1Reimbursement for MCOTT services shall be at a rate established by MAA.

4611.2MCOTT Providers shall be reimbursed at a flat rate of $ 63.00 for each day on which at least one face-to-face service for the Client is provided.

4611.3Each Provider shall agree to accept as payment in full the amount determined by MAA as the fee for the authorized services provided to Clients. Providers shall not bill the Client or any member of his/her family for MCOTT services.

4611.4Each Provider shall agree to bill any and all known third-party payers prior to billing Medicaid and comply with Medicaid third-party requirements under District and federal law.

4611.5Each Provider shall acknowledge that the payment and satisfaction of any Medicaid claim will be from federal and District funds, and agree that false claims, statements, documents, or concealment of material fact may be prosecuted under applicable federal and District laws.

4611.6MAA shall not reimburse a Provider for MCOTT services provided during a Client's inpatient psychiatric hospitalization.

source

Final Rulemaking published at 46 DCR 6122 (July 23, 1999).

                    
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