Section 29-9407. OWNERSHIP AND FINANCIAL DISCLOSURES

 

9407.1Each Applicant and relevant fiscal agents shall disclose, at the time of application, the following information for all persons with direct or indirect ownership or control interest that is equal to or greater than five percent (5%):

 

(a) Name;

(b) Address of any person (individual or corporation);

(c) Date of Birth;

(d) Social Security Number (individual); and

(e) Federal Tax Identification Number (corporation).

9407.2Applicants and Medicaid providers or suppliers also shall provide the information required in Subsection 9407.1 at any of the following times:

 

(a) Upon execution of the Provider Agreement;

 

(b) Upon request of DHCF during the revalidation process; and

 

(c) Within thirty-five (35) days following any change in ownership of the disclosing entity.

 

 

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).