This section establishes quality oversight and reporting obligations for Medicaid providers reimbursed under this chapter, which operates under an Section 1115(a)(2) SSA demonstration waiver. Providers must supply clinical, billing, and utilization data to DHCF, its designee, or CMS upon request as a condition of reimbursement. DHCF publishes provider guidance and any updates to quality oversight requirements on its website.
View official source8617 QUALITY OVERSIGHT AND PROVIDER REPORTING 8617.1 Medicaid reimbursement for services provided under this chapter are authorized under Section 1115(a)(2) of the SSA and are subject to evaluation and monitoring requirements consistent with the terms and conditions of the authorized demonstration. 8617.2 As a condition of reimbursement for services authorized under this chapter, providers are required to report any clinical, billing, or utilization information related to provision of service authorized under this chapter to DHCF, its designee, or CMS upon request. 8617.3 DHCF shall interpret provider guidance with regard to quality oversight and provider reporting requirements, or subsequent changes, on the DHCF website at HYPERLINK "http://www.dhcf.dc.gov" www.dhcf.dc.gov . SOURCE: Final Rulemaking published at 68 DCR 5406 (May 21, 2021). District of Columbia Municipal Regulations Public Welfare 29 DCMR § 8617