5012

5012.1 NPI numbers for Providers and staffing agencies, and all personnel delivering personal care services shall be included in all Medicaid billings.5012.2 Each Provider shall have a current organizational chart that clearly describes the organizational structure, management responsibilities, staff responsibilities, lines of authority, and use of any contractors.5012.3 Each Provider shall maintain current copies of all fully executed contracts including all staffing agency contracts pertaining to the delivery of personal care services, in the Provider's office and make them available to DHCF, CMS, and other authorized government officials or their agents when requested.5012.4 Each Provider shall maintain a copy of each license held by their employees and employees of any staffing agency utilized by the Provider for the delivery of personal care services.5012.5 A Provider shall be prohibited from waiving liability or assigning contract authority to any other entity for covered services provided to Medicaid beneficiaries.5012.6 Each Provider shall provide to all employees and contractors (such as staffing agencies providing staffing) a current policy manual which sets forth all of its policies and procedures.5012.7 Each policy manual shall include, but not be limited to, the following information:- (a) A description of the services to be provided;

- (b) Procedures for beneficiary care

- (c) The reimbursement methodology or fee schedules;

- (d) Operational schedules;

- (e) Quality assurance standards;

- (f) A statement of beneficiary rights and responsibilities;

- (g) Financial and record-keeping requirements;

- (h) Procedures for emergency care, infection control and reporting of incidents;

- (i) A description of staff positions and personnel policies, which shall be

reviewed annually, revised as necessary, and dated at time of review;

(j) Policies and procedures for hiring, performance assessments, grievances, and in-service training of all PCAs who deliver services, regardless of whether the PCA is an employee of the Provider or is secured through a staffing agency;

(k) An up to date listing of professional staff licensure and registration information;

(l) An up to date listing of PCA certifications;

(m) Policies and procedures for providing advance notice to beneficiaries in accordance with Section 5007; and

(n) Policies, procedures, and presentation materials for owners, managers, employees and contractual staff for in-service training on the following subjects:

1) Compliance with these regulations;

2) Compliance with federal and District False Claims Acts;

3) Preventing, detecting, and reporting fraud, waste, and abuse; and

4) Rights of employees to be protected as whistleblowers.

SOURCE: Notice of Final Rulemaking published at 59 DCR 1760, 1779 (March 2, 2012); as amended by Final Rulemaking published at 60 DCR 15537 (November 8, 2013).