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.

SOURCE: Final Rulemaking published at 70 DCR 008909 (June 23, 2023).