Ala. Admin. Code r. 560-X-9-.03

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

Section 560-X-9-.03 - Participation Requirements

(1) Independent laboratories must meet the following requirements for participation in the Alabama Medicaid program:

(a) Be certified for participation with Medicare.

(b) Have a valid CLIA certification (i.e., clinical labs).

(c) Have a Physician's supervisory Certification and utilize certified technicians for ultrasounds, Doppler services, and non-invasive peripheral vascular studies (i.e., physiological labs).

(d) Must be independent of any hospital, clinic, or physician's office.

(e) Be licensed in the state where located, when it is required by that state.

(f) Submit to routine audits by Medicaid.

(g) Complete an application with all required attachments.

(h) Sign a provider agreement.

(i) Sign a Direct Deposit Authorization.

Sign a Civil Rights Statement of Compliance.

(k) Effective date of enrollment will be the date of issuance of license. If license is not required in the state of residence, the effective date of enrollment will be the date of CLIA certification. However, providers who request enrollment more than 120 days after the above application date will be enrolled on the first day of the month the request for enrollment is received.

Author: Ginger Collum, Program Manager, Clinic/Ancillary Services

Ala. Admin. Code r. 560-X-9-.03

Rule effective October 1, 1982. Emergency Rule: effective October 15, 1990. Amended effective January 15, 1991; June 14, 1993. Amended: Filed September 8, 1998; effective October 13, 1998. Amended: Filed February 8, 2002; effective March 15, 2002.

Statutory Authority: State Plan; 42 C.F.R. §440.30; Title XIX, Social Security Act; 42 C.F.R. Section 493.2.