Conn. Agencies Regs. § 17b-262-599

Current through December 27, 2024

Section 17b-262-599 - Provider participation

(a)Billing Provider

In order to enroll in the Medical Assistance Program and receive payment from the department for early intervention services rendered, the billing provider shall:

(1) meet and maintain all departmental enrollment requirements;

(2) have a valid billing provider agreement on file which is signed by the billing provider and the department upon application for enrollment into the Medical Assistance Program. This agreement, which shall be periodically updated, shall continue to be in effect for the duration of the agreement or for the stated period in the agreement. The provider agreement specifies conditions and terms which govern the program and to which the billing provider is mandated to adhere in order to participate in the program;

(3) ensure that an individual employed or contracted by the performing provider shall be selected as service coordinator for each child to serve as the person responsible for compliance with the duties as defined in Title 34 CFR, Part 303, section 303.22;

(4) provide early intervention services directly or by means of a contract with qualified allied health professionals pursuant to all applicable federal and state statutes and regulations and ensure that all performing providers are enrolled with the Medical Assistance Program prior to provision of service;

(5) select one or more performing providers through a competitive or non-competitive bidding process;

(6) process all claims submitted by all other performing providers under contract for provision of early intervention services in the Birth to Three System; and

(7) comply with all Medical Assistance Program documentation and other requirements.

(b)Performing Provider

In order to enroll in the Medical Assistance Program as a performing provider the provider shall:

(1) have a contract with the billing provider;

(2) meet and maintain all departmental enrollment requirements;

(3) have a valid performing provider agreement on file which is signed by the performing provider and the department;

(4) provide all early intervention services directly with allied health professionals pursuant to all applicable provisions of federal and state statutes and regulations; and

(5) comply with all Medical Assistance Program documentation and other requirements.

Conn. Agencies Regs. § 17b-262-599

Effective August 28, 1998