Ala. Admin. Code r. 560-X-15-.06

Current through Register Vol. 42, No. 12, September 30, 2024

Section 560-X-15-.06 - Participation Requirements

(1) Dental clinics administered by the Alabama Department of Public Health may participate in the program if they are approved by and enter into a vendor agreement (contract) with Medicaid. Providers who meet the Alabama Medicaid Agency enrollment requirements are eligible to participate in the Alabama Medicaid Agency program. An enrollment application may be requested from the Medicaid fiscal agent or downloaded from the Medicaid website at www.medicaid.alabama.gov. Completed enrollment applications should be returned to Provider Enrollment at the address indicated on the form. Providers must complete an enrollment or an additional location enrollment application for each practice location.

(2) The Alabama Medicaid Agency will make payment for services to licensed, enrolled dental providers. All providers must meet the requirements to practice dentistry as set forth by the Alabama Dental Practice Act, Code of Ala. 1975, Section 34-9-6.

(3) In accordance with federal law, Medicaid providers shall ensure that no person will, on the grounds of race, color, creed, national origin, age or handicap, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program of services provided by the Agency. Compliance with Federal Civil Rights and Rehabilitation Acts is required of a provider participating in the Alabama Medicaid Program.

(4) Direct payments are made for allowance charges to providers for covered medical services and supplies furnished eligible Medicaid recipients.

(5) Refer to Chapter 20 concerning third party insurance carriers.

Ala. Admin. Code r. 560-X-15-.06

Rule effective October 1, 1982. Amended effective March 14, 1989; July 1, 1989. Emergency rule effective April 1, 1991. Amended effective June 12, 1991; April 14, 1992. Amended: Filed September 6, 2000; effective October 11, 2000. Amended: Filed May 12, 2004; effective June 16, 2004.

Amended by Alabama Administrative Monthly Volume XXXVI, Issue No. 12, September 28, 2018, eff. 10/26/2018.

Author: Charles D. Rush, DMD, Dental Program

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §§ 400, 100, 441.56.