201.000
Arkansas Medicaid Participation
Requirements
Individual and group providers of occupational therapy,
physical therapy and speech-language pathology services must meet the following
criteria to be eligible to participate in the Arkansas Medicaid Program.
A. A provider of therapy services must meet
the enrollment criteria for the type of therapy to be provided as established
and outlined in section
202.000 of this manual.
B. A provider of therapy services has the
option of enrolling in the Title XVIII (Medicare) Program. When a beneficiary
is dually eligible for Medicare and Medicaid, providers must bill Medicare
prior to billing Medicaid. The beneficiary may not be billed for the charges.
Providers enrolled to participate in the Title XVIII (Medicare) Program must
notify the Arkansas Medicaid Program of their Medicare provider number. Claims
filed by Medicare "nonparticipating" providers do not automatically cross over
to Medicaid for payment of deductibles and coinsurance.
C. The provider must complete and submit to
the Medicaid Provider Enrollment Unit a provider application (form DMS-652), a
Medicaid contract (form DMS-653) and a Request for Taxpayer Identification
Number and Certification (Form W-9). View or print a provider
application (form DMS-652), Medicaid contract (form DMS-653) and Request for
Taxpayer Identification Number and Certification (Form
W-9).
D. The
following documents must accompany the provider application and the Medicaid
contract.
1. A copy of all certifications and
licenses verifying compliance with enrollment criteria for the therapy
discipline to be practiced. (See section
202.000 of this
manual.)
2. If enrolled in the
Title XVIII (Medicare) Program, an out-of-state provider must submit a copy of
verification that reflects current enrollment in that program.
E. Enrollment as a Medicaid
provider is conditioned upon approval of a completed provider application and
the execution of a Medicaid provider contract. Persons and entities that are
excluded or debarred under any state or federal law, regulation or rule are not
eligible to enroll, or to remain enrolled, as Medicaid providers.
F. A copy of subsequent state license renewal
must be forwarded to the Medicaid Provider Enrollment Unit within 30 days of
issuance. If the renewal document(s) have not been received within this
timeframe, the provider will have an additional and final 30 days to
comply.
G. Failure to timely submit
verification of license renewal will result in termination of enrollment in the
Arkansas Medicaid Program.
H. The
provider must adhere to all applicable professional standards of care and
conduct.
201.110
School Districts and Education Service Cooperatives
If a school district or an education service cooperative
contracts with an individual qualified therapist or
speech-language pathologist, the criteria for group providers of therapy
services apply. The qualified individual is considered the provider of therapy
services and must complete an application and contract with the Division of
Medical Services. (Refer to section
201.100.)
The following requirements apply only to Arkansas school
districts and education service cooperatives that employ (via a form W-4
relationship) qualified therapists or qualified speech-language pathologists to
provide therapy services.
A. The
Arkansas Department of Education must certify a school district or education
service cooperative.
1. The Arkansas
Department of Education must provide a list, updated on a regular basis, of all
school districts and education service cooperatives certified by the Arkansas
Department of Education to the Medicaid Provider Enrollment Unit of the
Division of Medical Services.
2.
The Local Education Agency (LEA) number must be used as the license number for
the school district or education service cooperative.
B. The school district or education service
cooperative must enroll as a provider of therapy services. Refer to section
201.000 for the process to enroll
as a provider and for information regarding applicable restrictions to
enrollment.
203.000
Supervision
The Arkansas Medicaid Program uses the following criteria to
determine when supervision occurs within the Occupational, Physical, and Speech
Therapy Services Program.
A. The
person who is performing supervision must be a paid employee of the enrolled
Medicaid provider of therapy or speech-language pathology services who is
filing claims for services.
B. The
qualified therapist or speech-language pathologist must monitor and be
responsible for the quality of work performed by the individual under his or
her supervision.
1. The qualified therapist
or speech-language pathologist must be immediately available to provide
assistance and direction throughout the time the service is being performed.
Availability by telecommunication is sufficient to meet this
requirement.
2. When therapy
services are provided by a licensed therapy assistant or speech-language
pathology assistant who is supervised by a licensed therapist or
speech-language pathologist, the supervising therapist or speech-language
pathologist must observe a therapy session with the child and review the
treatment plan and progress notes at a minimum of every 30 calendar
days.
C. The qualified
therapist or speech-language pathologist must review and approve all written
documentation completed by the individual under his or her supervision prior to
the filing of claims for the service provided.
1. Each page of progress note entries must be
signed by the supervising therapist with his or her full signature, credentials
and date of review.
2. The
supervising therapist must document approval of progress made and any
recommended changes in the treatment plan.
3. The services must be documented and
available for review in the beneficiary's medical record.
D. The qualified therapist or speech-language
pathologist may not be responsible for the supervision of more than 5
individuals.
216.300
Procedures for Obtaining Extension of Benefits for Therapy
Services
A. Requests for extension of
benefits for therapy services for beneficiaries under age 21 must be mailed to
the Arkansas Foundation for Medical Care, Inc. (AFMC).
View
or print the Arkansas Foundation for Medical Care, Inc. contact
information. A request for extension of benefits must meet
the medical necessity requirement, and adequate documentation must be provided
to support this request.
1. Requests for
extension of benefits are considered only after a claim is denied because a
benefit is exhausted.
2. The
request for extension of benefits must be received by AFMC within 90 calendar
days of the date of the benefits-exhausted denial. The count begins on the next
working day after the date of the Remittance and Status Report (RA) on which
the benefits-exhausted denial appears.
3. Submit with the request a copy of the
Medical Assistance Remittance and Status Report reflecting the claim's denial
for exhausted benefits. Do not send a claim.
4. AFMC will not accept extension of benefits
requests sent via electronic facsimile (FAX).
B. Form DMS-671, Request for Extension of
Benefits for Clinical, Outpatient, Laboratory, and X-Ray Services, must be
utilized for requests for extension of benefits for therapy services.
View or print form DMS-671. Consideration
of requests for extension of benefits requires correct completion of all fields
on this form. The instructions for completion of this form are located on the
back of the form. The provider's signature (with his or her credentials) and
the date of the request are required on the form. Electronic signatures are
accepted. All applicable records that support the medical necessity of the
extended benefits request should be attached.
C. AFMC will approve or deny an extension of
benefits request - or ask for additional information - within 30 calendar days
of their receiving the request. AFMC reviewers will simultaneously advise the
provider and the beneficiary when a request is
denied.