D.C. Mun. Regs. tit. 29, r. 29-9404

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

Rule 29-9404 - SCREENING PROVIDERS OR SUPPLIERS CLASSIFIED AS "HIGH RISK"

9404.1

Pursuant to 42 C.F.R. § 455.450, the following provider and supplier types shall be classified within the "High Risk" category:

(a) Home Health Agencies ("HHAs") and

(b) Durable Medical Equipment, Prosthetics, Orthotics, and Supplies ("DMEPOS") suppliers.

9404.2

Screening for providers or suppliers classified as "High Risk" shall include the following:

(a) Verification that the provider or supplier meets requirements set forth in the D.C. Health Occupations Revision Act of 1985, as amended, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1201.01et seq.) and implementing rules, as well as all other applicable Federal and District laws and regulations;

(b) Verification of appropriate licensure, including licensure in states other than the District, in accordance with 42 C.F.R. § 455.412;

(c) Both pre- and post-enrollment database checks in order to ensure the provider or supplier continues to meet the enrollment criteria that corresponds to its provider or supplier type, in accordance with 42 C.F.R. § 455.436;

(d) On-site visits conducted in accordance with 42 C.F.R. § 455.432;

(e) Criminal background checks, pursuant to 42 C.F.R. § 455.434; and

(f) Submission of fingerprints, pursuant to 42 C.F.R. § 455.434, for all providers or individuals who maintain a five-percent (5%) or greater ownership interest in the provider or supplier.

D.C. Mun. Regs. tit. 29, r. 29-9404

Final Rulemaking published at 60 DCR 10041 (July 12, 2013)

Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2006 Repl. & 2012 Supp.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2008 Repl.)).