Current through Register Vol. 50, No. 9, September 20, 2024
A. In
order to participate as a provider of nursing services under Medicaid, a
facility must meet certification requirements and enter into a provider
agreement with the Department of Health and Hospitals. A provider agreement is
the basis for payments by the Bureau of Health Services Financing. The
execution of provider agreement and the assignment of the provider's Medicaid
vendor number is contingent upon the following criteria.
1. The facility shall request a Medicaid
enrollment packet from the BHSF/HSS Provider Enrollment Unit. The information
listed below shall be returned as soon as it is completed.
a. Two copies of the provider agreement form
which shall bear the signature of the person legally designated to enter into
the contract with DHH;
b. One copy
of the provider enrollment form, PE 50, which shall be completed in accordance
with accompanying instructions and bear the signature of the administrator or
authorized representative;
c. An
addendum to the above provider agreement shall be completed if the facility
chooses to provide any of the following enhanced levels of care:
i. a skilled-infectious disease
(S-ID);
ii. skilled-technology
dependent care (S-TDC);
iii.
skilled/neurological rehabilitation treatment program (S-NRTP).
B. Effective
date of the provider enrollment agreement. The effective date of the provider
agreement shall be determined as follows.
1.
If all federal requirements (health and safety standards) including facility
need review approval requirements specified above are met on the day of the
Health Standards Section survey, then the effective date of the provider
agreement is the date the on-site survey is completed.
2. If all requirements as specified in one
above are not met on the day of the HSS survey, then the effective date of the
provider agreement is the earlier of the following dates:
a. the date on which the provider meets all
requirements; and
b. the date on
which the provider submits a corrective action plan acceptable to the
HSS.
3. Upon receipt of
the above documentation/verification, Bureau of Health Services
Financing-Health Standards Section Provider Enrollment Unit will assign a
vendor number for billing purposes along with the issuance of the Provider
Agreement. The Fiscal Intermediary will be notified accordingly.
C. Provider Agreement Time
Periods. The provider agreement shall meet the following criteria in regard to
time periods.
1. It shall not exceed 14
months;
2. It shall coincide with
the certification period set by the Health Standards Section Survey Unit; and
EXCEPTION: If HSS has adequate documentation showing
"good cause", it may make an agreement and certification period for less than
12 months.
3. After a
provider agreement expires, payment may be made to a facility for up to 30
days.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
46:153.
