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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 29. PUBLIC WELFARE |
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Chapter 29-54. STANDARDS FOR MANAGED CARE PRIMARY CARE PROVIDERS THAT ARE PAID ON A FEE-FOR-SERVICE BASIS FOR SERVICES RENDERED TO AFDC AND AFDC-RELATED MEDICAID RECIPIENTS |
Section 29-5401. PROVIDER QUALIFICATIONS
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5401.1Each fee-for-service primary care provider shall execute a Medicaid managed care provider agreement with the Department.
5401.2Each fee-for-service primary care provider shall admit or refer all AFDC and AFDC-related Medicaid recipients requiring hospital care only to a hospital located in the District unless:
(a)Emergency care is required and a non-District hospital is the closest emergency facility to the recipient at the time of the emergency; or
(b)The enrollee requires a specialized service not available in a hospital located in the District.
5401.3Only physicians whose medical specialty is pediatrics, obstetrics/gynecology, internal medicine, family medicine or general medicine shall qualify as fee-for-service primary care physicians.