Regulation detail

Pa. Code 6100.81

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Pa. Code 6100.81 active

Jurisdiction: PA Agency: Pennsylvania Department of Human Services (OMHSAS) and Department of Drug and Alcohol Programs (DDAP)
IDD_COMMUNITY (100%)
Plain-English summary

This section establishes enrollment and ongoing compliance requirements for providers of Home and Community Based Services (HCBS) under Pennsylvania's IDD/developmental disability waiver program. Prior to and following enrollment, providers must meet applicable qualifications, comply with general Medicaid provider rules, complete pre-enrollment training, and hold valid regular licenses under the relevant Pennsylvania licensure chapters. The Department may deny enrollment if a prior sanction has been issued against the provider.

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Regulation text
55 Pa. Code § 6100.81 - HCBS provider requirements 

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(a)
 The
 provider shall meet the qualifications for each HCBS the provider intends to
 provide, prior to providing the HCBS.

(b)
 Prior to enrolling as a provider of HCBS,
 and on an ongoing basis following provider enrollment, the applicant or
 provider shall comply with the following: 
(1)

 Chapter 1101 (relating to general provisions).

(2)
 The Department's monitoring documentation
 requirements as specified in §
 
6100.42
 (relating to monitoring
 compliance).

(3)
 The Department's
 pre-enrollment provider training.

(4)
 Applicable licensure regulations,
 including Chapters 2380, 2390, 3800, 5310, 6400, 6500 and 6600; 28 Pa. Code
 Chapters 51, 601 and 611 (relating to general information; home health care
 agencies; and home care agencies and home care registries) and other applicable
 licensure regulations.

(c)

 Evidence of compliance with applicable licensure regulations in subsection
 (b)(4) is the possession of a valid regular license issued by the appropriate
 state licensure agency. 
(1)
 If the applicant
 possesses a provisional license for the specific HCBS for which the applicant
 is applying, the applicant is prohibited from enrolling in the HCBS program for
 that specific HCBS.

(2)
 This
 subsection does not prohibit a provider that possesses a provisional license
 from continuing participation in the HCBS program once a provider is
 enrolled.

(d)
 If the
 Department issued a sanction in accordance with §§
 
6100.741
-
6100.744
 (relating to
 enforcement), the Department may deny enrollment as a provider of
 HCBS.

Notes

55

 Pa. Code §
 
6100.81

This section cited in 55 Pa. Code §
 
6100.82
 (relating to HCBS
 enrollment documentation); 55 Pa. Code §
 
6100.802
 (relating to support
 coordination, targeted support management and base-funding support
 coordination); and 55 Pa. Code §
 
6100.805
 (relating to vendor goods
 and services).

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