5401.1 Each fee-for-service primary care provider shall execute a Medicaid managed care provider agreement with the Department.

5401.2 Each fee-for-service primary care provider shall admit or refer all AFDC and AFDC-related Medicaid recipients requiring hospital care only to a hospital located in the District unless:

(a) Emergency care is required and a non-District hospital is the closest emergency facility to the recipient at the time of the emergency; or

(b) The enrollee requires a specialized service not available in a hospital located in the District.

5401.3 Only physicians whose medical specialty is pediatrics, obstetrics/gynecology, internal medicine, family medicine or general medicine shall qualify as fee-for-service primary care physicians.

SOURCE: Final Rulemaking published at 42 DCR 1566, 1589 (March 31, 1995).