4018727 Requirements for Recertification

DEPARTMENT OF HEALTH CARE FINANCE

 

NOTICE OF EMERGENCY AND PROPOSED RULEMAKING

 

The Director of the Department of Health Care Finance (DHCF), pursuant to the authority set forth in 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 Supp.)), hereby gives notice of the adoption, on an emergency basis, of an amendment to chapter 42 (Home and Community-Based Waiver Services for Persons Who Are Elderly and Individuals with Physical Disabilities) of title 29 (Public Welfare), of the District of Columbia Municipal Regulations (DCMR). 

 

The Home and Community-Based Waiver Services for Persons Who Are Elderly and Individuals with Physical Disabilities (EPD Waiver) authorizes the District to provide services to eligible individuals in their home. The services provided under EPD Waiver are an alternative to institutional services.   Each individual receiving services under the EPD Waiver must be determined eligible prior to the receipt of services and recertified on an annual basis.  This amendment sets forth the documents that are required for recertification of eligibility for the EPD Waiver.   

 

This emergency rulemaking is necessitated by the immediate need to ensure that all individuals enrolled in the EPD Waiver are informed of the documentation required for recertification and continuation of services. Emergency action is necessary for the immediate preservation of the health, safety and welfare of persons who are receiving EPD Waiver services.   

 

The emergency rulemaking was adopted on October 31, 2012 and became effective on that date. The emergency rules will remain in effect for one hundred and twenty (120) days or until February 27, 2013 unless superseded by publication of a Notice of Final Rulemaking in the D.C. Register.  The Director also gives notice of the intent to take final rulemaking action to adopt this proposed rule not less than thirty (30) days from the date of publication of this notice in the D.C. Register.  

 

Section 4200 (General Provisions: Identification of Services; Authority of Operation; Targeting Restrictions) of title 29 (Public Welfare) of the DCMR is amended by adding section 4200.4 to read as follows:

 

4200.4             Each individual receiving home and community-based waiver services described in this chapter must be determined eligible prior to the receipt of services and recertified on an annual basis. The following documents must be completed and submitted at least sixty (60) days before the expiration date of the individual’s eligibility period:

 

(a)    Form 1209-W: Annual Plan of Care Medicaid Waiver Recertification;

(b)   Medicaid Level of Care; and

(c)    Proof of Income and Assets.      

 

Comments of the proposed rules shall be submitted in writing to Linda Elam, Ph.D., Deputy Director/Medicaid Director, Department of Health Care Finance, 899 North Capitol Street, N.E., 6^th Floor, Washington, DC 20002, via telephone on [phone], via email at [e-mail], or online at www.dcregs.dc.gov, within thirty (30) days after the date of publication of this notice in the D.C. Register. Copies of the proposed rules may be obtained from the above address.