D.C. Mun. Regs. tit. 29, r. 29-5301

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 29-5301 - PREPAID CAPITATED PROVIDER QUALIFICATIONS - GENERAL

5301.1

Each prepaid, capitated provider shall execute a Medicaid managed care provider agreement with the Department.

5301.2

Each prepaid, capitated provider shall admit or refer all AFDC and AFDC-related Medicaid recipients requiring hospital care only to a hospital located in the District unless:

(a) Emergency care is required and a non-District hospital is the closest emergency facility to the recipient at the time of the emergency; or

(b) The enrollee requires a specialized service not available in a hospital located in the District.

5301.3

Each prepaid, capitated provider shall maintain a staffed business office in the District.

D.C. Mun. Regs. tit. 29, r. 29-5301

Final Rulemaking published at 42 DCR 1566, 1567 (March 31, 1995)