Section 29-905. MEDICAID REIMBURSEMENT TO OUT-OF-STATE SKILLED NURSING AND INTERMEDIATE CARE FACILITIES

 

905.1Payment to a nursing home located outside of the District of Columbia serving D.C. Medicaid patients shall be in accordance with the rate schedule that applies to a nursing home provider under the Medical Assistance Program of the state where the nursing home is located. This rule does not apply to Forest Haven.

 

905.2This rule shall become effective on the beginning date of each facility's fiscal year occuring on or after January 1, 1985.

 

905.3The Department of Health, Medical Assistance Administration (MAA) shall not reimburse a nursing home located outside of the District of Columbia when an appropriate clinical placement is available in the District.

 

905.4Each out-of-state nursing home shall obtain written authorization from MAA prior to admission of D.C. Medicaid patients. Each request for authorization shall be submitted to the Public Health Analyst for Nursing Facilities, MAA, Office of Disabilities and Aging, 825 North Capitol Street, NE, 4th Floor, Washington, DC 20002.

 

905.5For purposes of this section, "nursing home" means a twenty-four (24) hour inpatient facility, or distinct part thereof, primarily engaged in providing professional nursing services, health-related services, and other supportive services needed by the patient/resident.

 

source

Final Rulemaking published at 51 DCR 7297 (July 23, 2004).