Section 29-5100. GENERAL PROVISIONS

 

5100.1These rules establish the standards and conditions of participation for providers of home health aide services ("Provider") under the District of Columbia Medicaid Program ("Medicaid Program").

 

5100.2A home care agency seeking reimbursement for home health aide services shall meet the conditions of participation for home health agencies set forth in Sections 1861(o) and 1891(e) of the Social Security Act and 42 CFR 484, and shall comply with the requirements set forth in the Health-Care and Community Residence Facility Act, Hospice and Home-Care Licensure Act of 1983, effective Feb. 24, 1984 (D.C. Law 5-48; D.C. Official Code, § 44-501 et seq), and implementing rules.

 

5100.3An entity seeking to participate as a provider of home health aide services under the Medicaid Program shall file an application on forms provided by the Department of Health, Medical Assistance Program (MAA).

 

5100.4The Provider Application shall contain, but not be limited to, the following information:

 

(a)Name and address of the Provider organization and location of all of the Provider's places of business in the District of Columbia and elsewhere in the United States;

 

(b)Names and addresses of the owners of the Provider organization;

 

(c)If the Provider organization is a corporation, the application shall include the names and addresses of all persons having a five percent (5%) or greater ownership interest and the names and addresses of all officers and directors of the organization; and

 

(d)The names and license numbers of the registered nurse or other appropriate health care professional who is responsible for supervising the home health aide.

 

5100.5A provider may contract with a personnel staffing agency for staff to perform home health aide services. Agreements between the provider and a contractor for the provision of home health aide services shall be in writing and shall include at a minimum, the following requirements:

 

(a)A description of the services to be provided;

 

(b)Location of where the services are to be provided;

 

(c)The manner in which the services are controlled, coordinated and evaluated by the home care agency;

 

(d)The procedure for developing plans of care, submitting clinical and progress notes, scheduling of visits, preparing patient evaluations and other designated reports;

 

(e)The procedures used for managing and monitoring the work of personnel employed on a contractual basis;

 

(f)The procedure for payment for services and payment terms for services furnished;

 

(g)The duration of the agreement, including provisions for renewal, if applicable; and

 

(h)Assurances that the contractor will comply with:

 

(1)All applicable agency policies, including the assurance that contract personnel meet the qualifications and fulfill the responsibilities of agency employees in accordance with these rules;

 

(2)All insurance and bonding requirements as set forth in section 5101 of these rules; and

 

(3)All applicable federal and District laws and rules.

 

5100.6A Provider must be certified by MAA as being in compliance with all requirements set forth in this chapter before participating in this Program.

 

5100.7Each Provider shall enter into an agreement with MAA that specifies the services to be provided, methods of operation, and financial and legal requirements.

 

5100.8Each Provider shall satisfy the requirements set forth in Title VI of the Civil Rights Law of 1964, including Section 504, which prohibits discrimination against the handicapped and comply with all applicable federal and District laws and rules.

 

source

Final Rulemaking published at 50 DCR 3957 (May 23, 2003).