PURPOSE: This rule establishes the requirements for service providers.

1. (1) Contractors or providers shall—

   1. (A) Ensure that all clients have a written referral from the client’s service coordinator to receive services prior to providing services;
   2. (B) Maintain complete financial and medical records to document services provided for each client;
   3. (C) Accept department reimbursement for eligible services by the provider as payment in full. The client or his/her family shall not be billed for any remaining balance after reimbursement has been made by the department; Child and Family Health
   4. (D) Notify the department in writing of a change of official name, address, federal ID, or tax identification number; and

   5. (E) Verify that all other payor sources have been exhausted prior to billing the department.

      1. 1. Contractors shall abide by and per-

form all the terms of their contract.

1. 2. All providers shall be licensed, regis-

tered, or certified by state agencies appropriate for their professions.

1. 3. The department may terminate con-

tracts or terminate providers from the program for violation of any applicable statute or regulation. A written notice indicating the termination shall be sent to the contractor/provider thirty (30) days prior to termination. The contractor/provider shall only be paid for services provided prior to the termination date.

1. 4. The department may review or moni-

tor providers at any time. Providers shall be contacted at least three (3) working days prior to the date of review and a list of client records may be requested for review. Followup visits may be required if problems are identified that require corrective action. AUTHORITY: sections 191.698–191.698, 192.006, 192.020, 192.025, and Chapter 213, RSMo (1994) and (Cum. Supp. 1996).* Emergency rule filed Nov. 21, 1996, effective Dec. 1, 1996, expires May 29, 1997. Original rule filed Dec. 10, 1996 effective May 30, 1997. *Original authority: 191.650–191.698 see Missouri Revised Statutes 1994 and Cum. Supp. 1996; 192.006, RSMo (1943), amended 1995; 192.020, RSMo (1939), amended 1945, 1951; 192.025, RSMo (1951); and Chapter 213, see Missouri Revised Statutes 1994 and Cum. Supp. 1996.