119 PAYMENT FOR REHABILITATION SERVICES

119.1 The Rehabilitation Services Administration shall pay only for services that are:- (a) Required to complete the assessment or evaluation process;

- (b) Identified on the client's Individualized Plan for Employment (IPE) or Independent Living Plan (ILP);

- (c) Preauthorized and approved by the Rehabilitation Services Administration through a signed purchase order or other authorizing document, pursuant to the D.C. Procurement Practices Act (D.C. Official Code § 2-301 et seq.) and procedures;

- (d) Determined satisfactory based upon the Rehabilitation Services Administration's evaluation of the services; and

- (e) Not available through a comparable service or benefit pursuant to § 114.119.2 The Rehabilitation Services Administration shall pay only the portion of the cost of services identified as the responsibility of the Rehabilitation Services Administration in the client's IPE or ILP, and shall not pay costs that have been designated as the client's financial responsibility.119.3 Each service provider who is subject to District of Columbia or other state licensure or certification requirements shall provide evidence of a valid license or certification before the Rehabilitation Services Administration may authorize the provider to render services to its clients. The provider shall maintain licensure or certification during each period of rendering the authorized services. Providers selected must be authorized prior to rendering services as a District vendor pursuant to the District of Columbia Procurement Practices Act (D.C. Official Code § 2-301 et seq.).119.4 Each college or university shall be accredited by an appropriate District, state, or national accrediting organization before the Rehabilitation Services Administration may authorize a client to attend that institution or authorize payment to that institution.119.5 A private career or proprietary school or other institution subject to regulation shall provide evidence of a valid license, certificate of approval or certification issued by the appropriate licensing or accreditation authority authorizing the institution to provide the specific courses of instruction or services the individual is seeking before the Rehabilitation Services Administration may authorize an individual to attend that institution or authorize payment to that institution.119.6 Each provider of services shall meet the requirements of the Americans with Disabilities Act (ADA) (42 U.S.C. § 12101 et seq.).119.7 Each provider shall submit a detailed, completed, and signed invoice for services rendered, along with any required reports or information, in accordance with procedures established by the D.C. Government, before the Rehabilitation Services Administration may authorize payment to the provider or initiate a payment request. The Rehabilitation Services Administration may return to the provider each invoice not properly signed, completed, and accompanied by required reports.119.8 A provider may not charge or accept payment from an individual client of the Rehabilitation Services Administration, the individual's family, or a third party for authorized services, unless the amount of the individual's financial responsibility to the provider has been:- (a) Preauthorized by the Rehabilitation Services Administration;

(b) Agreed to by the individual in writing; and

(c) Incorporated into the Rehabilitation Services Administration's written authorization for services to the provider.

119.9 The Rehabilitation Services Administration shall pay for authorized services at a rate not higher than the provider's customary charge.

119.10 The Rehabilitation Services Administration shall pay for all authorized services in accordance with the Procurement Practices Act (D.C. Official Code § 2-301 et seq.).

SOURCE: Final Rulemaking published at 50 DCR 6189 (August 1, 2003); as amended by Final Rulemaking published at 54 DCR 6020 (June 22, 2007).