D.C. Mun. Regs. tit. 29, § 9405
Screening Providers Designated as “Moderate” Risk
Effective Apr 23, 202168 DCR 4255Authority: 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
9405.1 Pursuant to 42 CFR § 455.450, the following provider types shall be assigned to the “moderate” risk category:
- (a) Adult day health service providers under the 1915(i) State Plan option;
- (b) Ambulance service suppliers;
- (c) Community mental health centers;
- (d) Comprehensive outpatient rehabilitation facilities;
- (e) Hospice organizations;
- (f) Independent clinical laboratories;
- (g) Independent diagnostic testing facilities;
- (h) Intermediate Care Facilities for Individuals with Intellectual Disabilities;
- (i) Pharmacies;
- (j) Portable x-ray suppliers; and
- (k) Providers of Home and Community Based Services (HCBS) under a 1915(c) waiver, including but not limited to the Elderly and Persons with Physical Disabilities (EPD) Waiver and the Individuals with Intellectual and Developmental Disabilities (IDD) Waiver.
9405.2 Screening for providers designated as “moderate” risk shall include the following:
- (a) Verification that the provider 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, including, where appropriate, the requirements of 42 CFR § 441.301(c);
- (b) Verification of appropriate licensure, including licensure in states other than the District, in accordance with 42 CFR § 455.412;
(c) On-site visits conducted in accordance with 42 CFR § 455.432; and
(d) Both pre- and post-enrollment federal database checks in order to ensure the provider continues to meet the enrollment criteria that corresponds to its provider type, in accordance with 42 CFR § 455.436
SOURCE: Final Rulemaking published at 60 DCR 10041 (July 12, 2013); as amended by Final Rulemaking published at 68 DCR 4255 (April 23, 2021).