Section 29-9405. SCREENING PROVIDERS OR SUPPLIERS CLASSIFIED AS "MODERATE RISK"

 

9405.1Pursuant to 42 C.F.R. § 455.450, the following provider and supplier types shall be classified within the “Moderate Risk” category:

 

(a) Community Mental Health Centers (“CMHCs”);

 

(b) Hospices;

 

(c) Home and Community Based Services (“HCBS”) Waiver providers;

 

(d) Intermediate Care Facilities for Individuals with Intellectual Disabilities (“ICFs/IID”); and

 

(e) Pharmacies.

 

9405.2Screening for providers or suppliers classified as “Moderate Risk” shall include the following:

 

(a) Verification that the provider or supplier meets requirements set forth in the D.C. Health Occupations Revision Act of 1985, as amended, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code  § 3-1201.01 et seq.) and implementing rules, as well as all other applicable Federal and District laws and regulations;

 

(b) Verification of appropriate licensure, including licensure in states other than the District, in accordance with 42 C.F.R. § 455.412;

 

(c) Both pre- and post-enrollment database checks in order to ensure the provider or supplier continues to meet the enrollment criteria that corresponds to its provider or supplier type, in accordance with 42 C.F.R. § 455.436; and

 

(d) On-site visits conducted in accordance with 42 C.F.R. § 455.432.

 

authority

An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2006 Repl. & 2012 Supp.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2008 Repl.)).

source

Final Rulemaking published at 60 DCR 10041 (July 12, 2013).