D.C. Mun. Regs. tit. 29, r. 29-9717

Current through Register Vol. 72, No. 2, January 10, 2025

Rule 29-9717 - DIRECTED PLAN OF CORRECTION (DPoC)

9717.1

In lieu of termination in situations where the ADHP is not in compliance with the programmatic requirements, and ADHP participants are not in immediate jeopardy, DHCF may require an ADHP to take prompt, or immediate action specified by DHCF to achieve and maintain compliance with programmatic requirements and other District of Columbia Medicaid requirements. These actions specified by DHCF shall constitute a Directed Plan of Correction (DPoC).

9717.2

The DPoC shall be developed by DHCF's Long Term Care Administration in coordination with the quality team of DHCF's Health Care Delivery Management Administration (HCDMA) and approved by, DHCF, incorporating findings from the provider's annual Providers Readiness Review.

9717.3

The DPoC shall specify:

(a) How corrective action shall be accomplished for participants found to have been affected by the deficient practice and include remedies that shall be implemented;

(b) How the provider shall identify other participants who may have been affected by the same deficient practice but not previously identified, and how the provider shall act to remedy the effect of the deficient practices for these participants;

(c) What measures and actions shall be put into place to ensure that the deficient practice(s) is/are being corrected and future noncompliance prevented;

(d) Timelines, including major milestones for completion of all corrective action in the DPoC;

(e) How compliance shall be determined; and

(f) How the DPoC relates to other alternative sanctions.

9717.4

A monitor from DHCF's HCDMA shall oversee implementation of the DPoC and evaluate compliance with the plan.

9717.5

DHCF may terminate the Medicaid provider agreement of an ADHP that is unable to meet the timeline for completion of all corrective actions in the DPoC.

D.C. Mun. Regs. tit. 29, r. 29-9717

Final Rulemaking published at 63 DCR 1031 (1/29/2016)