Section 405 IAC 5-21.7-13 - Provider reauthorizationAuthority: IC 12-8-6.5-5; IC 12-15
Affected: IC 12-13-7-3; IC 12-29; IC 25-23.6-10.5; IC 25-27.5-5
Sec. 13.
(a) To ensure continued compliance with provider qualifications and standards for providing CMHW services, an office-approved CMHW service provider must reapply for authorization according to the following reauthorization schedule: (1) An accredited agency provider must apply for reauthorization:(A) at least every three (3) years following the initial office authorization; or(B) at the time of the agency reaccreditation; whichever date is earlier.(2) A nonaccredited agency provider must apply for reauthorization at least every two (2) years following the initial office authorization.(3) An individual service provider must apply for reauthorization at least every two (2) years following the initial office authorization.(b) A provider must submit the application for reauthorization in writing to the office at least sixty (60) days prior to the due date for reauthorization.(c) An agency or individual provider applying for reauthorization as a CMHW service provider must complete the following application requirements: (1) Complete and submit the CMHW services provider reauthorization application to the office for review and consideration.(2) Submit documentation demonstrating that the individual provider or agency provider continues to meet all qualifications contained in section 10 of this rule.(3) Submit documentation demonstrating that the individual provider or agency provider continues to meet the qualifications for the CMHW service authorization being applied for, as defined in section 11 of this rule.(4) Submit documentation demonstrating compliance with the following:(A) Yearly provider continuing education training.(B) Updated certification requirements.(d) The office shall review the provider application and documentation to determine whether the agency or individual provider continues to meet the criteria for authorization as a CMHW service provider.(e) Failure to comply with authorization requirements in a timely manner will result in the following corrective action: (1) The agency or individual provider will be placed on suspended status as a CMHW services provider, pending the completion of the office reauthorization process.(2) The agency or individual provider must continue to provide services to those members whom the provider is currently serving, but will be prohibited from accepting any new members.(3) Upon the office's receipt and approval of the provider reauthorization paperwork, the status of the agency or individual provider will be updated to active status, thereby allowing the provider to accept new CMHW services members.(4) A provider's continued failure to comply with reauthorization requirements will result in the office's revoking authorization for that provider to deliver CMHW services.Office of the Secretary of Family and Social Services; 405 IAC 5-21.7-13; filed Dec 18, 2013, 11:13 a.m.: 20140115-IR-405130211FRAFiled 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRAErrata filed 11/1/2016, 9:36 a.m.: 20161109-IR-405160493ACAReadopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFAReadopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA