D.C. Mun. Regs. tit. 29, r. 29-11111

Current through Register 71, No. 45, November 7, 2024

Rule 29-11111 - INDIVIDUAL-DIRECTED GOODS AND SERVICES: PROVIDER REQUIREMENTS

11111.1

Individual-directed goods and services shall be provided only to IFS Waiver participants enrolled as participants in the My Life, My Way program.

11111.2

All individuals and vendors providing individual-directed goods and services shall meet the following minimum qualifications:

(a) All individuals providing individual-directed goods and services shall be at least eighteen (18) years of age;

(b) All individuals and vendors providing individual-directed goods and services shall be able to demonstrate to the participant that:

(1) The individual/vendor has the capacity to perform the requested work;

(2) The individual/vendor has the ability to successfully communicate with the participant; and

(3) The individual/vendor has all the necessary professional and/or commercial licenses and accreditations required by federal and District law.

11111.3

No individual or vendor shall be reimbursed by Medicaid for any individual-directed good or service that is not:

(a) Documented in the participant's ISP and PDS budget; and

(b) Approved by DDS.

11111.4

An individual or vendor selected by a participant to provide individual-directed goods or services on a recurrent basis shall be required to enter into a District of Columbia Medicaid provider agreement prior to providing the goods or services.

11111.5

The VF/EA FMS-Support Broker entity shall verify that an individual or vendor selected by the participant to provide individual-directed goods and services meets all applicable requirements set forth in §1111.2 at the time of enrollment into the VF/EA FMS-Support Broker entity's provider payment system and thereafter, as necessary.

D.C. Mun. Regs. tit. 29, r. 29-11111

Final Rulemaking published at 70 DCR 8909 (6/23/2023)