Ala. Admin. Code r. 560-X-12-.03

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-12-.03 - Provider Requirements For Participation

(1) Only instate agencies are eligible for participation.

(2) A home health agency is a public agency, private non-profit organization or proprietary agency which is primarily engaged in providing part-time or intermittent skilled nursing services and home health aide services to patients in their homes.

(3) To become a Medicaid home health care provider, the home health agency must:

(a) Be certified to participate as a Medicare provider;

(b) Be certified by the Division of Health Care Facilities of the Alabama Department of Public Health as meeting specific statutory requirements and as meeting the Conditions of Participation;

(c) Request in writing to Alabama Medicaid Agency (Medicaid) to become a provider of Medicaid home health care, and enclose a copy of the agency's most recent cost study report showing discipline costs; and

(d) Agree to sign and to comply with the terms set forth in the agreement with Medicaid.

(4) Medicare cost reports must be available for review by the Alabama Medicaid Agency upon request.

(5) A copy of any Medicare audit adjustment or settlement must be submitted to Medicaid within thirty (30) days of receipt by the home health agency.

Authors: Priscilla Miles, Associate Director, LTC Program Management Unit

Ala. Admin. Code r. 560-X-12-.03

Rule effective October 1, 1982. Amended effective February 9, 1988; September 9, 1988. Amended: Filed November 21, 2002; effective December 26, 2002.

Statutory Authority: Title XIX, Social Security Act; 42 C.F.R. §440.70; State Plan.