D.C. Mun. Regs. tit. 29, § 9404
Screening Providers Designated as “Limited” Risk
Effective Jul 12, 201360 DCR 10041Authority: An Act to enable the District of Columbia (District) to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat.744; D.C. Official Code §1-307.02 (2016 Repl. & 2019 Supp.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2018 Repl.)). Source: Final Rulemaking published at 60 DCR 10041 (July 12, 2013); as amended by Final Rulemaking published at 68 DCR 4255 (April 23, 2021).District of Columbia, Office of the Secretary
9404
SCREENING PROVIDERS OR SUPPLIERS CLASSIFIED AS “HIGH RISK”
9404.1 Pursuant to 42 C.F.R. § 455.450, the following provider and supplier types shall be classified within the “High Risk” category:
- (a) Home Health Agencies (“HHAs”) and
- (b) Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DME POS”) suppliers.
9404.2 Screening for providers or suppliers classified as “High Risk” shall include the following:
- (a) Verification that the provider or supplier meets requirements set forth in the D.C. Health Occupations Revision Act of 1985, as amended, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1201.01 et seq.) and implementing rules, as well as all other applicable Federal and District laws and regulations;
- (b) Verification of appropriate licensure, including licensure in states other than the District, in accordance with 42 C.F.R. § 455.412;
- (c) Both pre- and post-enrollment database checks in order to ensure the provider or supplier continues to meet the enrollment criteria that corresponds to its provider or supplier type, in accordance with 42 C.F.R. § 455.436;
- (d) On-site visits conducted in accordance with 42 C.F.R. § 455.432;
- (e) Criminal background checks, pursuant to 42 C.F.R. § 455.434; and
- (f) Submission of fingerprints, pursuant to 42 C.F.R. § 455.434, for all providers or individuals who maintain a five-percent (5%) or greater ownership interest in the provider or supplier.
SOURCE: Final Rulemaking published at 60 DCR 10041 (July 12, 2013).