Ala. Admin. Code r. 560-X-38-.02

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

Section 560-X-38-.02 - Participation

(1) In order to participate in the Title XIX Medicaid Program and to receive Medicaid payment for services, ASC providers must meet all of the following requirements:

(a) Certification for participation in the Title XVIII Medicare Program;

(b) Approval by the appropriate licensing authorities;

(c) Compliance with Title VI of the Civil Rights Act of 1964 and with Section 504 of the Rehabilitation Act of 1973; and

(d) Submit a letter requesting enrollment, a copy of a transfer agreement with an acute care facility (refer to Rule 560-X-38-.05 for details), and enter into a contract with the Alabama Medicaid Agency.

(e) Reimbursement is limited to services provided directly by the facility's staff in accordance with the capability as specified on the HCFA-377.

(2) The fiscal agent will be responsible for enrolling any Title XVIII (Medicare) certified Ambulatory Surgery Centers that wish to be enrolled as Qualified Medicare Beneficiary (QMB) only providers.

Authors: Vicki W. Huff, Carol Akin.

Ala. Admin. Code r. 560-X-38-.02

Rule effective September 1, 1986. Amended effective July 13, 1989; September 10, 1992.

Statutory Authority:42 C.F.R. §§ 416.2, 416.39, 416.40; Medicare Catastrophic Coverage Act of 1988, ( Public Law 100-360).