Current through Register Vol. 24-18, September 15, 2024
(1) To
continue to provide services for eligible clients and be paid for those
services, a provider must:
(a) Provide all
services without discriminating on the grounds of race, creed, color, age, sex,
sexual orientation, religion, national origin, marital status, the presence of
any sensory, mental or physical handicap, or the use of a trained dog guide or
service animal by a person with a disability;
(b) Provide all services according to federal
and state laws and rules, medicaid agency billing instructions, provider alerts
issued by the agency, and other written directives from the agency;
(c) Inform the agency of any changes to the
provider's application or contract including, but not limited to, changes in:
(i) Ownership (see WAC
182-502-0018
);
(ii) Address or telephone
number;
(iii) The professional
practicing under the billing provider number; or
(iv) Business name.
(d) Retain a current professional state
license, registration, certification or applicable business license for the
service being provided, and update the agency of all changes;
(e) Inform the agency in writing within seven
calendar days of changes applicable to the provider's clinical
privileges;
(f) Inform the agency
in writing within seven business days of receiving any informal or formal
disciplinary order, disciplinary decision, disciplinary action or other
action(s) including, but not limited to, restrictions, limitations, conditions
and suspensions resulting from the practitioner's acts, omissions, or conduct
against the provider's license, registration, or certification in any
state;
(g) Screen employees and
contractors with whom they do business prior to hiring or contracting, and on a
monthly ongoing basis thereafter, to assure that employees and contractors are
not excluded from receiving federal funds as required by
42
U.S.C. 1320a-7 and 42 U.S.C.
1320c-5;
(h) Report immediately to
the agency any information discovered regarding an employee's or contractor's
exclusion from receiving federal funds in accordance with
42
U.S.C. 1320a-7 and 42 U.S.C. 1320c-5. See WAC
182-502-0010(2)(j)
for information on the agency's screening process;
(i) Pass any portion of the agency's
screening process as specified in WAC
182-502-0010(2)(j)
when the agency requires such information to reassess a provider;
(j) Maintain professional and general
liability coverage to the extent the provider is not covered:
(i) Under agency, center, or facility
professional and general liability coverage; or
(ii) By the Federal Tort Claims Act,
including related rules and regulations.
(k) Not surrender, voluntarily or
involuntarily, the provider's professional state license, registration, or
certification in any state while under investigation by that state or due to
findings by that state resulting from the practitioner's acts, omissions, or
conduct;
(l) Furnish documentation
or other assurances as determined by the agency in cases where a provider has
an alcohol or chemical dependency problem, to adequately safeguard the health
and safety of medical assistance clients that the provider:
(i) Is complying with all conditions,
limitations, or restrictions to the provider's practice both public and
private; and
(ii) Is receiving
treatment adequate to ensure that the dependency problem will not affect the
quality of the provider's practice.
(m) Submit to a revalidation process at least
every five years. This process includes, but is not limited to:
(i) Updating provider information including,
but not limited to, disclosures;
(ii) Submitting forms as required by the
agency including, but not limited to, a new core provider agreement;
and
(iii) Passing the agency's
screening process as specified in WAC
182-502-0010(2)(j).
(n) Comply with the employee
education requirements regarding the federal and the state false claims
recovery laws, the rights and protections afforded to whistleblowers, and
related provisions in Section 1902 of the Social Security Act (
42 U.S.C.
1396a(68)) and chapter 74.66
RCW when applicable. See WAC
182-502-0017
for information regarding the agency's requirements for employee education
about false claims recovery.
(2) A provider may contact the agency with
questions regarding its programs. However, the agency's response is based
solely on the information provided to the agency's representative at the time
of inquiry, and in no way exempts a provider from following the laws and rules
that govern the agency's programs.
(3) The agency may refer the provider to the
appropriate state health professions quality assurance commission.
(4) In addition to the requirements in
subsections (1), (2), and (3) of this section, to continue to provide services
for eligible clients and be paid for those services, residential treatment
facilities that provide substance use disorder (SUD) services (also see chapter
246-337 WAC) must:
(a) Not deny entry or
acceptance of clients into the facility solely because the client is prescribed
medication to treat SUD;
(b)
Facilitate access to medications specific to the client's diagnosed clinical
needs, including medications used to treat SUD;
(c) Make any decisions regarding adjustments
to medications used to treat SUD after individual assessment by a prescribing
provider;
(d) Coordinate care upon
discharge for the client to continue without interruption the medications
specific to the client's diagnosed clinical needs, including medications used
to treat SUD. See
RCW
71.24.585.
Statutory Authority:
RCW
41.05.021 and 42 C.F.R. 455. 13-03-068,
§182-502-0016, filed 1/14/13, effective 2/14/13. 11-14-075, recodified as
§182-502-0016, filed 6/30/11, effective 7/1/11. Statutory Authority:
RCW
74.08.090,
74.09.080, and
74.09.290. 11-11-017, §
388-502-0016, filed 5/9/11, effective
6/9/11.
